http://bit.ly/FilnerHearingOnPersonalityDisorderDischarges September 15, 2010 Wednesday HEARING OF THE HOUSE VETERANS AFFAIRS COMMITTEE; SUBJECT: "PERSONALITY DISORDER DISCHARGES: IMPACT ON VETERANS' BENEFITS"; CHAIRED BY: REPRESENTATIVE BOB FILNER (D-CA); WITNESSES: SERGEANT CHUCK LUTHER, VETERAN, KILLEEN, TEXAS; JOSHUA KORS, INVESTIGATIVE REPORTER, THE NATION MAGAZINE; PAUL SULLIVAN, EXECUTIVE DIRECTOR, VETERANS FOR COMMON SENSE; THOMAS BERGER, EXECUTIVE DIRECTOR, VIETNAM VETERANS, AMERICA'S VETERANS HEALTH COUNCIL; DEBRA DRAPER, DIRECTOR OF HEALTH, GOVERNMENT ACCOUNTABILITY OFFICE (GAO); LERNES HEBERT, ACTING DIRECTOR, OFFICER/ENLISTED PERSONNEL MANAGEMENT, DEFENSE DEPARTMENT OF DEFENSE; JACK SMITH, DEPUTY ASSISTANT DEFENSE SECRETARY FOR CLINICAL AND PROGRAM POLICY; MAJOR GENERAL GINA FARRISEE, DIRECTOR, DEPARTMENT OF MILITARY PERSONNEL MANAGEMENT, G-1, U.S. ARMY; COLONEL REBECCA PORTER, CHIEF, BEHAVIORAL HEALTH, OFFICE OF THE SURGEON GENERAL OF THE ARMY; ANTONETTE ZEISS, ACTING DEPUTY CHIEF PATIENT CARE SERVICES AND OFFICER FOR MENTAL HEALTH, OFFICE OF PATIENT CARE SERVICES VETERANS HEALTH ADMINISTRATION; THOMAS MURPHY, DIRECTOR, VA COMPENSATION AND PENSION SERVICE; LOCATION: 334 CANNON HOUSE OFFICE BUILDING, WASHINGTON, D.C. BODY:    HEARING OF THE HOUSE VETERANS AFFAIRS COMMITTEE SUBJECT: "PERSONALITY  DISORDER DISCHARGES: IMPACT ON VETERANS' BENEFITS" CHAIRED BY: REPRESENTATIVE BOB FILNER (D-CA) WITNESSES: SERGEANT CHUCK LUTHER, VETERAN, KILLEEN, TEXAS; JOSHUA KORS, INVESTIGATIVE REPORTER, THE NATION MAGAZINE; PAUL SULLIVAN, EXECUTIVE DIRECTOR, VETERANS FOR COMMON SENSE; THOMAS BERGER, EXECUTIVE DIRECTOR, VIETNAM VETERANS, AMERICA'S VETERANS HEALTH COUNCIL; DEBRA DRAPER, DIRECTOR OF HEALTH, GOVERNMENT ACCOUNTABILITY OFFICE (GAO); LERNES HEBERT, ACTING DIRECTOR, OFFICER/ENLISTED PERSONNEL MANAGEMENT, DEFENSE DEPARTMENT OF DEFENSE; JACK SMITH, DEPUTY ASSISTANT DEFENSE SECRETARY FOR CLINICAL AND PROGRAM POLICY; MAJOR GENERAL GINA FARRISEE, DIRECTOR, DEPARTMENT OF MILITARY PERSONNEL MANAGEMENT, G-1, U.S. ARMY; COLONEL REBECCA PORTER, CHIEF, BEHAVIORAL HEALTH, OFFICE OF THE SURGEON GENERAL OF THE ARMY; ANTONETTE ZEISS, ACTING DEPUTY CHIEF PATIENT CARE SERVICES AND OFFICER FOR MENTAL HEALTH, OFFICE OF PATIENT CARE SERVICES VETERANS HEALTH ADMINISTRATION; THOMAS MURPHY, DIRECTOR, VA COMPENSATION AND PENSION SERVICE; LOCATION: 334 CANNON HOUSE OFFICE BUILDING, WASHINGTON, D.C. TIME: 10:00 A.M. EDT DATE: WEDNESDAY, SEPTEMBER 15, 2010    REP. FILNER:  Good morning. The hearing of the Committee of Veterans Affairs will come to order. I apologize for our late start. As many of you know, we just went through a markup that took a little longer than we had counted on. And I would ask unanimous consent that all members may have five legislative days with which to revise and extend their mark. So ordered.    Let me just give some background. If the first panel can move up to the front, that would be fine.    In 2007, this committee held a hearing to explore the problem of the Department of Defense allegedly improperly discharging service members with pre-existing personality disorders, rather than mental health commissions, resulting from the stresses of war such as post- traumatic stress disorder or traumatic brain injury. This means that service members with personality disorder discharges are generally denied key military disability benefits and the DOD is conveniently relieved from the responsibility of caring for our service members in the long term.    These men and women continue to face an uphill battle when they seek benefits and services at the Department of Veterans Affairs because they must somehow prove that the so-called pre-existing condition was aggravated or worsened by their military service.    Following our 2007 hearing, the National Defense Authorization Act for fiscal year 2008 included a provision requiring DOD to submit a report to Congress on this issue. And DOD reported that from 2002 to 2007, the department discharged 22,600 service members with personality disorders.    By the way, when the DOD has a chance to testify, I would like to just see if they can cover the question, given this large number of discharges, why were they accepted in the first place, is what I would like to know.  DOD policy further stated that service members must be counseled, be given the opportunity to overcome said deficiencies, and must receive written notification prior to being involuntarily separated on the basis of a personality disorder.  DOD also added rigor to their policy guidance by authorizing such separations only if service members are diagnosed by a psychiatrist or Ph.D.-level psychologist of the personality disorder.    It has been over three years since we first exposed this issue at our hearing in 2007.  I should say after it was exposed in the press we took it up, and Mr. Kors, who did a lot of research on this, we're glad to have here today and we appreciate his -- all his work.    Mr. Kors and Sergeant Luther, can you come up now so you can be ready?    It is my understanding that DOD's use of personality disorder discharges has decreased and that they concluded that no soldiers have been wrongly discharged.    I am rather puzzled by this conclusion and would like to better understand the process and the criteria that were used to review the files of the thousands of service members who were discharged with personality disorders.  I cannot help but suspect that our men and women are not getting the help that they need and are struggling with PTSD, TBI and other stresses of war on their own because of the wrong personality disorder discharges.    The stresses of war that we call PTSD are -- we know are debilitating and its impact can be far- reaching.  We know of the negative impact that PTSD and TBI can have on the individual's mental health, physical health, work and relationships. We also know that veterans attempt to self-medicate using alcohol and drugs. This means that PTSD and TBI can lead veterans on a downward spiral toward suicide attempts and homelessness.    Just this past summer we all heard that the United States Army reported suicide rates of over 20 per 100,000, which now exceeds the national suicide rate of about 19 per 100,000 in the general population.  And when high risk behavior such as drinking and driving and drug overdoses are taken into account, it is said that more soldiers are dying by their own hand than in combat.    Similarly, we know that homelessness continues to be a significant problem for our veterans, especially those suffering with PTSD and TBI.    Now, three years later, the committee continues to hear of accounts of wrongful personality disorder discharges.  This begs the question of how many soldiers have to commit suicide, go bankrupt and end up homeless before real action is taken to remedy this problem.    Clearly, our veterans must not be made to wait longer and must not be denied the benefits they are entitled to.  I look forward to hearing from our witnesses today as we further expose the problem of personality disorder discharges, better understand the steps that DOD has taken to deal with this problem, and forge a path forward to help our service members who were improperly discharged with personality disorders.    When Mr. Buyer returns, I will be happy to give him time to do an opening statement.    The first panel is made up of Sergeant Chuck Luther, a veteran who will tell his own story of having personally experienced this practice.  I mentioned Joshua Kors, who is an investigative reporter for The Nation magazine and who has done some real pioneering research in this.  And we thank you, Mr. Kors, for your service to the nation in this regard.    Mr. Kors, you have time before the committee.    MR. KORS:  (Off mike) -- personality disorder, pardon me.    Good morning. I have been reporting on personality disorder for several years, and I'm here today to talk about the thousands of soldiers discharged with that condition since 2001.    A personality disorder discharge is a contradiction in terms. Recruits who have a severe pre-existing illness like a personality disorder do not pass the rigorous screening process and are not accepted into the Army.    In the three and a half years I have been reporting on this story, I have interviewed dozens of soldiers discharged with personality disorder.  All of them passed that original screening and were accepted into the Army.  They were deemed physically and psychologically fit in a second screening as well before being deployed to Iraq and Afghanistan and served honorably there in combat.    In each case, it was only when they became physically wounded and sought benefits that their pre-existing condition was discovered.    The consequences of a personality disorder discharge are severe. Because P.D. is a pre-existing condition, soldiers discharged with it cannot collect disability benefits, they cannot receive long-term medical care like other wounded soldiers, and they have to give back a slice of their signing bonus. As a result, on the day of their discharge thousands of injured vets learn they actually owe the Army several thousand dollars.    Sergeant Chuck Luther is a disturbing example of how the Army applies a personality disorder discharge.  Luther was manning a guard tower in the Sunni Triangle north of Baghdad when a mortar blast tossed him to the ground, slamming his head against the concrete, leaving him with migraine headaches so severe that vision would shut down in one eye. The other, he said, felt like someone was stabbing him in the eye with a knife.    When Luther sought medical care, doctors at Camp Taji told him that his blindness was caused by pre-existing personality disorder. Luther had served a dozen years, passing eight screenings, and winning 22 honors for his performance.    When he rejected that diagnosis, Luther's doctors ordered him confined to a closet. The sergeant was held in that closet for over a month, monitored around the clock by armed guards who enforced sleep deprivation, keeping the lights on all night, blasting heavy metal music at him all through the night.    When the sergeant tried to escape, he was pinned down, injected with sleeping medication and dragged back to the closet.    Finally, after over a month, Luther was willing to sign anything, and he did, signing his name to a personality disorder discharge. The sergeant was then whisked back to Fort Hood where he learned the disturbing consequences of a P.D. discharge.  No disability pay for the rest of his life, no long-term medical care, and he would now have to pay back a large chunk of his signing bonus. Luther was given a bill for $1,500 and told that if he did not pay it, the Army would garnish his wages and start assessing interest.    Since 2001, the military has pressed 22,600 soldiers into signing these personality disorder documents, at a savings to the military of over $12.5 billion in disability and medical benefits.    The sergeant's story was part three in my series on personality disorders. In part two, I interviewed military doctors who talked about the pressure on them to purposely misdiagnose wounded soldiers. One told the story of a soldier that came back with a chunk missing from his leg. His superiors pressured him to diagnose that as personality disorder.    In 2008, after several congressmen expressed outrage at these discharges, President Bush signed a law requiring the Pentagon to study P.D. discharges. Five months later, the Pentagon delivered its report. Its conclusion? Not a single soldier had been wrongly diagnosed and not a single soldier had been wrongly discharged.    During its five-month review, Pentagon officials interviewed no one, not even the soldiers whose cases they were reviewing.    Three years ago, during a hearing on personality disorder discharges, military officials sat in these seats and vowed to this committee to fix this problem.  Three years later, nothing has happened.    REP. FILNER:  Thank you, Mr. Kors.    Sergeant Luther, thank you for being here. Thank you for your service. And I know it's not easy to talk about your personal situation, but we do appreciate it.    SGT. LUTHER:  Mr. Chairman, committee members and guests, thank you for the opportunity to speak and help my fellow soldiers and veterans by telling my story.    I am here today to say that wearing the uniform for the U.S. Army is what defined me. I was and still am very proud of the service I gave to my country.    I entered the service on active duty training status in February of 1988.  I served five months on active duty training status and went to eight years of honorable reserve service. I had a break in service and re-entered the Reserves in 2003, and after serving eight months honorably, I enlisted into the active duty Army in October of 2004.  I was stationed at Fort Hood, Texas. I served as an administrative specialist for three years and was given several awards for my leadership and service.    I then went to retrain to become a 19 Delta Cavalry Scout. Upon finishing school at Fort Knox, Kentucky, I returned to Fort Hood and was assigned to Comanche Troop, 1-7 Cav, 1st Brigade, 1st Cavalry Division. I held the rank of specialist, E4, when we left for Taji, Iraq, for a 15-month combat deployment.    We arrived in Iraq in November of 2006. We found ourselves in a very violent area at the beginning of the surge.    On December 16, 2006, I was working in the company radio area monitoring the group that we had outside the forward operating base on an escort mission. I remember that day very clearly. The call came in from one of our staff sergeants in that patrol that they had been attacked and one of our vehicles had been destroyed and we had three killed and one wounded.    As we were receiving the information, we could hear the small arms fire in the background as they tried to recover the dead and wounded soldiers.    I served as the training room noncommissioned officer, so I was asked to translate the combat numbers given over the radio to my commander and first sergeant for identity.  As the information came over, I instantly realized that the truck had been destroyed contained one of my closest friends, Staff Sergeant David Staats, and one of the soldiers that I had taken under my wing, PFC Joseph Baines.    I focused on the mission at hand and that evening drove the first sergeant and the platoon sergeant of these soldiers to the mortuary affairs to helped unload their bodies from the vehicles bringing them home.    I pushed through and the next morning we got word as we were preparing to head to Baghdad to see the wounded soldier that he also passed away.    For the next two months, we lost several other soldiers from our squadron and two Iraqi interpreters.    On February 16, 2007, I was a member of a convoy that drove out four boats and members of our troop to conduct a river recon/mosque monitoring mission. After an uneventful drive out, unloaded the boats, the troops and the soldiers, we headed back to the Forward Operating Base Taji.    As we pulled back on FOB, the call came over the radio that the unit of soldiers had been ambushed on the river mission. We had to quickly gather up troops and head back to the drop off location to assist.    Upon arriving, we received small arms and large-scale fire from the enemy. We found one of our staff sergeants lying in the middle of the beach bleeding from both legs, one of our lieutenants had been shot in the arm, and two Iraqi police officers had been killed.    We quickly put together two boats of troops and ammo to retrieve our soldiers. After heading up river we had received fire on our boat and the boat had capsized and we were stranded on an island for approximately 14 hours before being picked up. We had limited ammunition and no radio communications. We all thought we were going to die that day.    Fourteen days to the day after that event, I was sent home for R&R leave. I was very angry, had severe headaches, was depressed and would cry at times. I fought with my wife and family while I was at home. I had an episode where I broke my hand punching walls.    After not being able to cope, I welcomed the trip back to Iraq. Upon returning to Iraq, I was promoted to sergeant and received my Combat Action Badge for my part in the river mission firefights.    After returning from R&R leave, several people in my unit said that something had changed in me.  I tried to pull it together but had trouble sleeping, had anger problems, severe headaches, nose bleeds and chronic chest pain. I was living at the combat outpost X-ray.    While there, I went to see the medics to get my inhaler for asthma refilled. I was sent back to the forward operating base, and upon returning to the aid station, the squadron aide station doctor was not present. I was told he was busy preparing for his triathlon that he would be competing in after our deployment.    I came back the next day and was seen. I asked to see the chaplain because I was feeling very depressed and needed to talk. After talking to the chaplain, I was sent to the quarters for two days and then I was allowed to go back to the combat outpost.    Around the first of April, I was in guard tower 1 alpha when a mortar landed between the tower and the wall around the combat outpost. When it exploded, it threw me down, I hit my right shoulder and head. I had severe ringing in my right ear with clear fluid coming from it and had problems seeing out of my right eye.    After a few minutes, I went to the medics on the outpost and was given ibuprofen and water and sent back to duty.    I started to have worse headaches and could not sleep. They sent me back to the forward operating base and I was seen by the -- (inaudible) -- aid station doctors and medics and then sent to the mental health center. I spoke with a lieutenant colonel there who was a licensed clinical social worker. He had a 15-minute talk with me and they gave me Celexa and Ambien.  I was sent back to my quarters. The next two days I began to get angry and hostile due to the medications and I was sent back to the lieutenant colonel. He informed me that if I did not stop acting like this that they were going to chapter me out under a 5-13, personality disorder discharge.    I tried and went back to the aid station.  After several days on suicide watch for making the comment that "if I had to live like this I would rather be dead," I asked to be sent somewhere where I could get help and to be able to understand what was wrong with me.  I was told I could not go and demanded that I be taken to the inspector general of the forward operating base. I was told by Captain Dewees that I was not going anywhere and he called for all the medics, roughly six to 10.  I was assaulted, held down, and had my pants ripped from my left thigh and given an injection of something that put me to sleep.    When I awoke, I was strapped down to a combat litter and had a black eye and cuts on my wrists from the zip ties. I eventually was untied and from that point forward for five weeks, I was held in a room that was six feet by eight feet that had bed pans, old blankets and other old supplies. I had to sleep on a combat litter and had a wool blanket. I was under guard 24/7 and on several occasions was told I was not allowed to use the phone or the Internet.  I had slept through chow and asked to be taken to the chow hall or P.X. to get some food due to my medications.    I was told no and given a fuel-soaked MRE to eat. I was constantly called a piece of crap, a faker, and other derogatory things. They kept the lights on and played all sorts of music, from rap to heavy metal, very loud all night.  The medics worked in shifts, therefore, they didn't sleep; they rotated.    These are some of the tactics that we would use on insurgents that we captured to break them to get information or confessions. I went through this for four weeks and the HHC commander told me to sign this discharge and that if I didn't they would keep me there for six more months and then kick me out when we got back to Fort Hood anyway.    I said I didn't have a personality disorder and he told me that if I signed the paperwork that I would get back home and get help and I would have all my benefits.    After the endless nights of sleep deprivation, harassment and abuse, I finally signed just to get out of there.  I was broken.    It took more -- two more weeks before I was flown out and brought to Fort Hood. Upon returning, I was told by the rear detachment acting first sergeant and commander to stay out of trouble and they would get me out of there.  I was sent out to wait on my wife in the rain with two duffel bags and another carry bag. This was my welcome home from war.    I went home and I went to sleep only to be awakened by three sergeants at my door saying that I had to go back to mental health due to me being suicidal and they had not had me checked out.  I went to the R&R center at Fort Hood, Texas and was seen by a lieutenant colonel who was a psychologist. He asked why I was brought back from Iraq. I explained they said I had a personality disorder and he disagreed, he shook his head and said that I had severe PTSD and combat exhaustion. He told me to get some sleep and rest and follow up in a week with him. I was never allowed to go back to see him.    The ironic thing is that in my military records I held three Army jobs and had a total of eight mental health screenings that all found me fit for duty. Also, I've had never had a negative counsel nor a negative incident in my 12 years of Reserve and active duty career.    Two weeks after getting back, I was discharged from the Army, I had my pay held and they took my saved up leave from me for repayment of unearned reenlistment bonus.  I received a notice in the mail three weeks after my discharge from the Department of Finance that I owed the Army $1,501.  Three months later, I went to the VA and I was told they could not see me for the mental health due to my preexisting disorder.    I went back the next week and was seen by a psychologist. After an hour with her she scheduled me an appointment with a caseworker and then I had several follow-up mental health appointments.  I was given my VA rating a year later in 2008 of 70 percent for post-traumatic stress disorder, knee injury, headaches, right shoulder and asthma.    Six months later, after several emergency room visits and neurology appointments, my rating was upgraded to 90 percent and I was given service-connection for Traumatic Brain Injury.    In June of this year, after two years from the date that I filed a request with the Military Boards of Correction to have my discharge changed from a Chapter 5-13 to a medical retirement, I was denied, even after the three years of VA medical documents and evidence from people who know me. I demand that my discharge be changed and I receive the proper discharge for my service.    I have since founded Disposable Warriors and I've assisted many veterans and soldiers in a range of issues from personality disorder diagnosis to soldiers on active duty with diagnosed post-traumatic stress disorder that are not being treated or being discharged for misconduct under the other than honorable or bad conduct discharge, which also does not entitle them to VA benefits.    I want to say that it has been hell just get my mind somewhat back on track and to exist; I have bouts of memory loss, agitation, flashbacks, paranoia, problems sleeping and depression. I get angry every time I look at my DD-214 with the fraudulent personality disorder discharge. It's cost me contract jobs for private security after my exit from the Army.  I had to get a job three days after I was kicked out of the Army to feed my wife and three children.    I was taught for years in the Army the definition of integrity, honor, respect and selfless service, all of which I gave to the Army, but none was given back to me.    I hold two things very dear to me to this day, and it comes from the noncommissioned officers' creed:  the accomplishment of my mission and the welfare of my soldiers.  I am on a new battlefield, with a new mission, and I will at all cost take care of soldiers and their families.    I love my country, I love my Army, but we cannot stand by and watch this continue to happen. At the very same time this committee was having Specialist Jon Town testify in front of them in July of 2007; I was abused, broken and discharged at the -- for the very same thing that he was testifying about.    Please do not let us be here in three years again with another story of shame. The lack of care and concern, coupled with the stigma of weakness for asking for help that we have allowed to be put on us, has got to be totally removed.  Then, and only then, will we see the veterans homeless rate drop, the active duty and veteran suicide rate drop, and the skyrocketing rate of divorce decrease.    The senior level of the armed forces get it, but they can talk about it, design plans for it, and make PowerPoints about it, but if it's not being enforced at the soldier's level, it is worthless.    In closing, I would like to state that I do not have, nor have I ever had, a personality disorder.  I suffer from post-traumatic stress injury and traumatic brain injury from my service to my country while at war in Iraq. I raised my right hand on several occasions and swore to protect the Constitution at all cost. I did my part. Now it's time for the military to keep its part of the agreement that if I were injured they would help me get back on my feet.    Please help stop these wrongful discharges and help get our wounded service men and women back to service or back home to their families.    Thank you.    REP. FILNER:  Well, thank you for -- both for such compelling testimony.    Mr. Kors, the last figure that both you had and I had were from 2002 to 2007, that they had discharged 22,600.  Is there any new -- has that gone -- has that numbers gone down since we had that first hearing or --    MR. KORS:  They've added 200 more to the list, but even that is tremendously outdated. That goes to 2007.    REP. FILNER:  So we don't know what's happened in the last three years, roughly?    MR. KORS:  We don't at all. I mean, I think the number of families who have been purposely cheated out of benefits is just rising and rising without stop.    REP. FILNER:  I mean, I assume the later panels are here and heard that question. I hope that that's answered. I am sure such an institution as the Army has more update figures, right? I mean we would assume?    MR. KORS:  I hope so. And it's worth mentioning this is not just the Army. We're seeing personality disorder discharges across all four branches.    REP. FILNER:  What did they -- what disorder did they have you down for Mr. Luther?    SGT. LUTHER:  They have me a personality disorder, NOS, not otherwise specified. They didn't characterize it.    REP. FILNER:  Nothing more specific than that?    SGT. LUTHER:  No, sir.    MR. KORS:  And that's something you see with all of these discharges. When you have wounds that clearly don't come from a personality disorder, a cleaner way to fudge it is to give a non- psychological, non-accurate diagnosis, NOS.    You won't find that in any of the psychological manuals, but it prevents them from stating specifically, you know, what the issue is.    And of course, I mean, these discharges are being used for some of the most absurd things. Of course with him, with blindness, with Jon Town here three years ago after he was wounded by the rocket and won the Purple Heart, they said he wasn't wounded, that his deafness came from personality disorder.    I think about Sergeant Jose Rivera, his arms and legs were punctured by grenade shrapnel. They said those shrapnel wounds were caused by personality disorder.  Sailor Samantha Spitz, her pelvis and two bones in her ankle were fractured. They said that her fractured pelvis was caused by personality disorder.    And in the case that really touched me, I think of Specialist Bonnie Moore. She developed an inflamed uterus during service. They said her profuse vaginal bleeding was caused by personality disorder.    Civilian doctors thought it was something a little more severe. She went to a hospital in Germany where they removed her uterus and appendix, but after being given that personality disorder discharge and denied all benefits, she and her teenage daughter became homeless. She called me just because she was concerned that at the homeless shelter her daughter would be raped.    REP. FILNER:  Sergeant Luther, what you described in the month or so after when they asked you to sign these papers can only be described as torture as I listen to it.  Did you take any legal action against the Army for torturing you?    SGT. LUTHER:  No, sir. At the time my TDS attorney told me just go ahead and sign it or I would stay there six months, and when I got out it took approximately 90 days for me to even get out of my -- my fog to even seek help, and when I went to the VA, when they immediately denied me at first, and some psychologist, I don't recall her name, heard me talking and asked me to come back -- (inaudible) -- but I've not been able to take any legal action. We went through the proper channels to ask the Board of Corrections to take the evidence and look at it. And I just recently got a copy of that back and it was pretty astounding.    REP. FILNER:  I'll ask some later panels but maybe Mr. Kors knows, does he have any legal status? I mean any --    MR. KORS:  No.    REP. FILNER:  (Inaudible) -- to sue the Army for torture?    MR. KORS:  The Feres Doctrine coming out of the Supreme Court case from 1950, Feres v. U.S., provides a bubble for military doctors which, regardless of how egregious their behavior or diagnosis is, they cannot be sued.    A lot of the doctors I talked to who were pressured to purposely misdiagnose physical injuries as personality disorder, that was one of the tactics that their superiors gave them. Said, look, you can go ahead and do this. You'll be promoted for applying the false diagnosis and there's no way you can be sued because of the Feres --    REP. FILNER:  But it sounds like during this containment, there were other people beside doctors involved, so I mean, are there any --    MR. KORS:  I think legally it would be a tricky prospect.    REP. FILNER:  All right.    Mr. Buyer?    REP. STEVE BUYER (R-IN):  Mr. Chairman, I'm going to refer to my opening statement and I'm going to make another statement.    The Department of Defense has the responsibility to ensure that diagnosis of personality disorders within its ranks are accurate and the behavior abnormalities are not the consequence of combat or some other event that might result from post-traumatic stress.    That being said, this committee does not have jurisdiction over the military disabilities rating system, nor the discharge procedures. I made this very point three years ago when we held a nearly identical hearing on how the Pentagon handles the identification and disposition of personality disorder diagnosis.    Today's hearing takes a slightly different approach as to how personality disorder discharges impact veterans benefits, but the thrust of the discussion is the same.    This is primarily a DOD issue and if we hope to prompt any effective solutions, we should have had a joint hearing with the Armed Services Committee. As for the topic of today's hearing, I think most participants can summarize pretty quickly how personality disorder discharges impacts a veteran's benefits. Personality disorders are not considered diseases for VA compensation purposes, and except in cases where they were proximity due to or aggravated by a service-connected condition.    Clearly, if the VA provides a different diagnosis than the military, then the condition is considered to have been an incurred on active duty; service connection may be then established.    So the crux of the problem we're discussing lies with the accuracy of the diagnosis provided by military physicians. And if we question whether the misdiagnosis, if there is one, is due to deliberate actions by some nefarious purpose, my sensing, as the testimony -- as I listened to the testimony by a reporter, and they are simply the result, maybe even of medical errors or a line of inquiry that leads back to the DOD.    I expect we're going to hear here from the DOD in their response to the issues raised by the 2008 GAO report that showed that in many instances DOD was not following their own procedures and policies regarding personality disorder discharges. GAO will testify that even after they can still not reasonably say that all the services are following DOD policies on personality disorders.    Now, what is really challenging here for me is I just want to be really careful. Number one, Sergeant Luther, let me thank you for your willingness to serve the country and wear America's uniform, the United States Army, the same uniform that I've worn for 30 years, so I respect that.    I also have a lot of documents here about you that are non- disclosable and I'm not going to discuss them in public. So when you make statements, though, you've made public statements, and I am not going to go into your personal life. I'm not going to discuss your military conditions.    But when you make certain statements and you're sitting to your left is a reporter that makes some very exaggerated statements, you disadvantage DOD. They're going to come up here and, guess what, they can't specifically talk about your case. They can't come in here and testify about some of the things that you have said. You've made some pretty strong statements that are not supported by what I have.    And I'm disadvantaged also because, number one, I'm disadvantaged out of respect. I respect you. I respect your privacy.    I also would say this:  I would never, even when I was chairman of whatever subcommittee or full committee, ever put a reporter on a panel to testify. I would never do that. Why? Because your testimony is hearsay. It's hearsay. Everything you say is hearsay.    What we're supposed to do is get to the bottom of things and so we can understand them. You can make whatever allegations you want, you can lead us to the -- to our professional staff and then we can find the person, so the testimony is in first person.    So I'd say to the gentleman, you can say whatever you say, and basically you have, and you surmised your opinion based on what you've seen and heard. But I think it's pretty shocking that you would even come here and -- and provide testimony with regard to someone's medical condition. You're not a doctor. If you were a doctor they'd knock you right upside the head for that.    I'd be pretty upset if you went and testified about my medical conditions in a public place, let alone where are your sensitivities to talk about a woman and her health? Wow. I'm pretty shocked that you would do that.    So I'm going to yield back my time, Mr. Chairman. I just want you to know, sir, I respect you and I could be more than -- gosh, I could go into this. But, sir, follow my -- my counsel would be is follow the counsel of some individuals that really -- that really have your interest at heart, and those doctors have your interest at heart.    You're upset with regard to a diagnosis on your -- on a personality disorder. PTSD in fact has been recognized. I have the records with regard -- the findings from the -- when you attempted to correct the military records. And so I've seen everything that they've said, and I've seen the documents with regard to that process.    I think what we want -- we want you to get better. We want you to get better with regard to the PTSD. And please follow -- follow the counsel of your doctors and mental health professionals that take you, your interests best at heart, not somebody else that may want to use you or use your case to write stories or to do other things.    If they truly had your interest at heart, they wouldn't take your case and what I know about you and put it on public display. That's Steve Buyer's opinion. I would never do that to a fellow soldier.    With that, I yield back.    REP. FILNER:  Thank you, Mr. Buyer.    Would either of you like to make a comment, please? Make sure your mike's on.    MR. KORS:  I'd love to address these concerns. Thank you, Congressman Buyer.    First of all, as for this being hearsay, I hope it's clear that this is the furthest thing from that.  As a reporter, I'm here to summarize the three and a half years of research I've done on personality disorder, with Sergeant Luther's case particularly.    I never would have gone into this investigation if it were a he said, she said story.  In addition to Sergeant Luther's detailed testimony, I have stacks of medical papers from his doctors at Camp Taji, who documented his confinement. I have an interview with his commander, who was there at the aid station and confirmed every piece of this story.  I have -- I interviewed Sergeant Byington, who came to visit him while he was confined in the closet.    I also, one of the idiosyncrasies of this story is they did not take away Sergeant Luther's backpack, which had his camera. He was able to document the closet, take photos of it.    Nobody in this story disputes that this is what happened. The only question from here is what to do about it.    As for this being an isolated case, I think about Troy Daniels (sp), a doctor who works extensively with Fort Hood.  He interviewed -- or he, sorry, treated Sergeant Luther following his return to Texas, said in no way did he have a personality disorder, this was clearly traumatic brain injury, and that he wasn't surprised by this, he had seen a dozen of these personality disorder cases come out of Fort Hood. All of them, he said, did not have personality disorder.    I'm simply giving back to you the statements from the doctors I've spoken with.    REP. BUYER:  And the challenge is, you can't say an emphatic statement like you just said. All said he does not have. I have all the -- I have records in front of me.    (Cross talk.)    MR. KORS:  I'm sorry, all said what?    REP. BUYER:  I'm not going to do this. I can't -- my integrity as a gentleman will not permit me to do this.    Dr. Roe, will you take this seat? I will not participate in this. I'm not going to do it. I'm not going to do it. This is wrong -- (inaudible).    Dr. Roe, would you take over?    REP. FILNER:  Mr. Kors, Sergeant Luther, any further reaction please, sir?    (Cross talk.)    REP. FILNER:  Please.    MR. KORS:  His mike's not on. Let me just say further that the representative was upset that I was sharing Specialist Bonnie Moore's story. I mean, these soldiers want their stories to be told.    You know, Sergeant Luther, I believe he came here today to represent those 22,600 families who have been shattered by these false diagnoses. It's a story that hasn't gotten out to the public, as so many in the military hope it would, and if nobody knows about this, if these stories don't get out, then this problem is not going to be fixed.  We'll be here, as Sergeant Luther said, three years later with another batch of stories.    REP. FILNER:  I think you have control over your mike. There's a button on there that you can control.    SGT. LUTHER:  Just what I'd like to say is this, is I'm not here just about Chuck Luther. This is larger than I.  I haven't made any statements that were inflammatory or wrong.  I wished I didn't have this story to tell.    But what I will tell you is in the three years that I've been treated for post-traumatic stress disorder and the medications I've been given, several of my doctors all have said to me at different intervals to make sure I continue to fight to have my discharge changed, because it doesn't reflect what my injury is.    I saw a licensed clinical social worker and a pediatrician in a combat theater for less than two hours of face time and was given the diagnoses of personality disorder.  In doing studying over three years that is impossible to diagnose at that interval.    In fact, in the last three years I've been treated -- prognosed and diagnosed for my PTSD, and now traumatic brain injury due to my cognitive function disability, and if it was a case of a personality disorder, I think that those licensed psychologists and psychiatrists would, in fact, have found a personality disorder in seeing that I have never in my life had any issues prior to being blown up in Iraq.    MR. KORS:  Mr. Chairman, let me also add, one misimpression I want to make sure the folks from this committee do not come away with is that there is any kind of connection between P.D., personality disorder, and PTSD. They have similar letters. As Mark Twain said, the difference between lightning and the lightening bug.    It is true that Sergeant Luther did get shell shock from his service in Iraq, but we're talking about physical injuries that are being diagnosed as personality disorder.    You know, with PTSD it's very easy to make this amorphous argument that, well, you know, you think he was crazy before -- or after he served in Iraq, we think he was crazy before, I guess we both have our own opinion. With blindness, deafness, a mortar fire wound, fractured pelvises, you can't make that same argument.    REP. FILNER:  Thank you.    Mr. Roe, do you have any questions since -- (inaudible)?    REP. PHIL ROE (R-TN):  Not much. I didn't hear a lot of the testimony. But just as a veteran and as a medical officer in the Army when I was in, I never felt any pressure. I never had anyone -- maybe I was immune to it, I don't know, maybe just stubbornness -- but I never felt pressure to make a diagnosis one way or the other.  And certainly diagnosis can be right and be wrong.  I guess the Roe's rule is they hadn't invented the test or the diagnosis that hadn't been wrong.  So people can make mistakes, honest mistakes.    But as a medical doctor, in the military, I never had anyone come to my clinic and pressure me to diagnose someone one way or the other so that an administrative discharge or whatever could be made.  I'm not saying that did or didn't happen, I'm just saying the experience of this doctor it didn't happen. So I yield back.    REP. FILNER:  I thank you.    Mr. Kors, Sergeant Luther, I hope you will stay for the next panels. We may want to have you respond to what happened.    I want to in contrast, I guess, to the ranking member, I want to thank you for your courage for being here.  I want to thank you for pursuing this. You're up against a vast machine of arguments, you know, that you just saw here.    And I think it's extremely important that all the families get the best possible kind of explanation, and by telling your story, sergeant, you have tried to help that.    Mr. Kors, there is nobody who has ever testified in front of this committee that didn't use some hearsay or other. I have read all your stuff.  I have talked to you. I have great confidence in both the ethics and the integrity of what you have said and the way you go about it.    So I want to thank you both for your courage and for your integrity for doing this.    MR. KORS:  Thank you. Mr. Chairman, if I could quickly address two concerns that were raised by Representative Roe.    First to say that, you know, you had asked before about the consequences for these doctors, whether they'd be subject to lawsuits. Quite the opposite has been occurring. Those who have provided these false diagnoses have been rapidly promoted.    I think about Lieutenant Colonel Applewhite, the social worker who diagnosed personality disorder on Sergeant Luther.  He was immediately given a slot to teach at Fort Sam Houston, a course to other medical professionals on how to properly diagnose mental illnesses.    With Major -- with Captain Wehri, who confirmed that Sergeant Luther was placed in that closet for over a month, he was promoted to major.    And those -- and in fact with that doctor I mentioned who was encouraged to diagnose that chunk of a missing leg as personality disorder, the superior who applied that pressure was immediately promoted to one of the top doctors in the military.    And also to address the concern of Representative Buyer that this is not -- this is an Army issue and not a VA issue. Nothing could be further the truth because so many of these soldiers, they're told, "You've got a personality disorder discharge, you're not eligible for VA benefits." So these people don't go to the VA because they don't think they have a slot there for them. The very, very few that find out through other means, like maybe the press, that they can get an independent review from the VA, they'll go in and in those cases you get the most bizarre outcomes.    You have VA doctors who get to examine them in depth and say this soldier doesn't have a personality disorder, they have a broken arm, or blindness, or traumatic brain injury. And then you have what you have in Sergeant Luther's case with traumatic brain injury and a large disability benefit finally for that injury, but yet the Army is insisting that he has a personality disorder discharge and doesn't deserve any compensation. One soldier, two vastly different diagnoses.    REP. ROE:  Chairman, may I just make a comment?    Mr. Kors, I don't know the details of this and I'm just discussing this in the broader view. If I served in the military, that I thought my promotion was based on me making a diagnosis, it isn't the Army that I was in. And you may be -- maybe an officer got promoted after they saw someone, I'm sure I did. I got promoted from captain to major when I was in the Army; I saw a lot of people during that time.    But the military has criteria that they do, objective criteria, hoops that you jump through, at least when I was in the Army, to get promoted.  It's not -- I've never heard of any such thing where somebody made a diagnosis and then you suggest that they got promoted because of it. That would be outrageous.    MR. KORS:  Well, this is not to say that this was the only reason they were promoted. But, you know, in the case of the doctor who was pressed to diagnose the missing chunk of the leg, he came to me and said, "I want to speak out about this, but I was not going to do it." He retired immediately instead of providing that diagnosis.    REP. ROE:  I yield back.    REP. FILNER:  Again, thank you. I hope you will stay because we may want to recall you for -- after we hear the other two.    If panel two will come forward, please.    Thank you for being here. Paul Sullivan is the executive director of Veterans for Common Sense; Dr. Thomas Berger is the executive director for the Veterans Health Council, the Vietnam Veterans of America. We appreciate your being here today.    The minority has not requested any background medical conditions on yourself, so we'll be fine.    Mr. Sullivan?    MR. SULLIVAN:  Mr. Chairman, yes, I brought my glasses, that's my medical condition. I need to read my testimony.    I thank you, Chairman Filner and Ranking Member Buyer, for inviting Veterans for Common Sense to testify about the impact of improper military discharges on our veterans.    VCS testified about this issue three years ago. We remain alarmed DOD continues improperly discharging thousands of our service members who had entered the military in good health and who served with honor while deployed to the Iraq and Afghanistan wars.    DOD may have reduced the number of personality disorder discharges, and that should be noted. But DOD now improperly uses adjustment disorder and pattern of misconduct discharges instead.    While we believe the military causes the problems associated with improper discharges, the solution requires cooperation between Congress, the military, VA and advocates.    According to an Army Times article, quote, "Jason Perry, a former Army judge advocate who helps troops going through medical retirement, said he has seen dozens of such cases. It's very common and it's completely illegal." Unquote.    We agree with Mr. Perry's assessment. VCS urges Congress to order an immediate stop to DOD's improper personality disorder, adjustment disorder and pattern of misconduct discharges for those service members deployed to the war zone since 2001.    The main underlying cause of the improper discharges remains the enormous pressure from Secretary Gates to curb military medical spending. VCS estimates between $5 billion and $20 billion in lost lifetime medical and other benefits for our veterans and families.    DOD's policies improperly shifts cost from the federal government to veterans and private insurance companies, as well as to state and local governments.    VCS remains frustrated the military has not revealed how many of our Iraq and Afghanistan war service members were administratively discharged since 2001. We need facts if we are going to stop the improper discharges and provide VA care and benefits to otherwise deserving veterans.    VCS used the Freedom of Information Act to try to obtain this information from DOD, and DOD said they could not obtain the data due to computer limitations.    As advocates, we want to offer solutions please.    First, VA training. VA should train benefits and health care staff about DOD discharges to avoid improper VA denials for health care and benefits.    Two, there should be new DOD regulations. DOD should update separation rules to provide greater legal protections for service members.    Three, correct records. DOD should identify and correct as many as 22,000 previous inappropriate discharges. Four, enforce accountability. DOD must improve oversight and accountability. We are troubled that not a single military officer was fired or reprimanded for apparently or allegedly violating service members' rights.    Independent review. Congress should create an independent review of the overall health of our service members. Otherwise, the absence of records allows DOD to plead ignorance, just as they did with exposures to radiation from atomic bomb blasts, Agent Orange and Gulf War illness.    Six, conduct universal mandatory medical exams. VCS once again urges Congress to order the military to implement mandatory universal pre-deployment and post-deployment physical exams as required by the 1997 Force Health Protection Act that will help alleviate some of the problems with confusing records.    Seven, fill mental health professional vacancies. VCS urges Congress to order the military to hire more medical professionals so our soldiers receive the mandatory universal exams, as well as prompt treatment.    Eight, honor medical opinions. VCS urges Congress to eliminate the ability of line commanders to overrule the decisions made by medical professionals regarding the ability of the service member to deploy to a war zone.    Nine, expand anti-stigma education. VCS urges DOD and VA to expand the agency's anti-stigma education program and to encourage our service members and veterans to seek care when needed.    In conclusion, DOD is responsible for most of the problems discussed here today. However, implementing pragmatic solutions requires cooperation between Congress, the military, VA and advocates.    This concludes my testimony, Mr. Chairman. I would be happy to answer any of your questions.    REP. FILNER:  Thank you, Mr. Sullivan.    Dr. Berger?    MR. BERGER:  Chairman Filner -- Chairman Filner, Ranking Member and distinguished members of the committee who are still around here, on behalf of President John Rowan, our board of directors and our membership, Vietnam Veterans of America, thank you for the opportunity to present our views on discharges for personality disorders and their impact on veteran benefits.    We've heard a great deal of pieces and parts about the history.    I think it's important to remember that personality disorder is a severe mental illness that emerges during childhood or adolescence and is listed in military regulations as a pre-existing condition, not a result of combat. Personality disorder contains symptoms that are enduring and play a major role in most, if not all aspects of a person's life. While many disorders vacillate in terms of symptom presence and intensity, personality disorders typically remain relatively constant.    In other words, according to the DSM-IV, to be diagnosed with a disorder in this category the symptoms have been present for an extended period of time, are inflexible and pervasive, and are not a result of alcohol or drugs or another psychiatric disorder, and the history of symptoms can be traced back to childhood or adolescence.    At the time the issue first arose back in 2007, VVA and other veterans advocates, some of whom are present in this room, contended publicly and in meetings with Congress that many of the service members were suffering from post-traumatic stress disorder or traumatic brain injury, but that it was easier and less costly for the military to separate them under the rubric of personality disorder, leaving some of us to believe that such a large number of personality disorder discharges -- remember, 22,600 plus -- were in fact fabricated to save on the cost of other, more appropriate mental health treatments and disability benefits.    We've also heard from the chairman, himself, about some of the history of the hearings that have gone on since 2007.  I'd point out a couple of other elements missing from the history here, and that is in August of 2008, Department of Defense, DOD issued an instruction that took effect, without public announcement, okay, that revised how they were to apply the personality disorder discharge.    In addition, that same summer, the Senate also adopted an amendment to the defense authorization bill at the time by then- Senator Obama, Senator Kit Bond and Senator Lieberman from Connecticut that directed DOD officials to report on the personality disorder situation.    They did so. Subsequently, in October of 2008, GAO released its findings based on a review of service jackets for 312 members separated for personality disorder from four military installations. It concluded that the services were not reliably compliant even with the pre-August 2008 regulation governing discharge separations. And, for example, only 40 to 78 percent of enlisted members separated for personality disorder had documents in their files showing that a psychiatrist or qualified psychologist determined that their disorder affected their ability to function in the service.    Fast forward to 2010. We now hear the Army say that any soldier -- they deny that any soldier was misdiagnosed before 2008. All right? But if you look the number of PTSD cases, that jumped, okay? Between 2008 and 2009, something happened.    And so we'd like to ask, okay, can the Army explain why the number of the personality disorder discharges doubled between 2006 and 2008 and then shrunk after that by 75 percent? And how many of those who got those discharge separations were qualified to retain their benefits?  I would also like to follow up with Paul's question.  Is the Army now relying on a different designation referred to as adjustment disorder to dismiss soldiers.    It's absolutely clear either through congressional action or a presidential directive that the Army needs to conduct a thorough review of its personality disorder diagnoses prior to 2008, treat those who need help, and restore disability benefits where appropriate.    Thank you, Mr. Chairman, Mr. Roe, for holding this meeting. Glad to answer any questions.    REP. FILNER:  Thank you, Dr. Berger.    Mr. Roe?    REP. ROE:  Just a couple. I have a meeting I've got to go to at noon, but a couple of quick questions. And, Dr. Berger, you may have the answer to this. I don't and I hadn't studied this issue before I came here today.    But do you know the incidence of personality disorder in the population in general?    MR. BERGER:  No. I can't give you that figure, sir, not off the top of my head.    REP. ROE:  I wondered if the -- I guess the question I have in what percent of troops had -- were diagnosed with personality disorder. In other words, we've had 22,600, what percent of our troops that are in there have been diagnosed and is that -- is that -- do you see what I'm getting at is, it's higher or is this a diagnosis that all of a sudden has exploded in the military, but it's not out there in real life.    And your description of personality disorder is correct, at least my familiarity with it is, is it usually manifests itself in childhood or --    MR. BERGER:  And adolescence. I mean, DSM-IV is clear on it, sir.    (Cross talk.)    REP. ROE:  Kids are acting out and whatever, you have trouble dealing with them in high school and so on. They usually don't get to the military.    But I think that's a couple -- I mean some -- just some demographics that would be very interesting to see. What is -- what is the incidence in the population in general? What's the diagnosis of that? And then what is -- is it higher here? Have we used this diagnosis?    And I think you could find out those two things you'd find out a lot. I think your question about between 2006 and 2008, where the incidence doubled and then dropped down; I think that begs an answer also.    MR. BERGER:  Right. Well, thank you, sir. We're skeptical of the Army's claim that it didn't make any mistakes, because the symptoms of PTSD -- anger, irritability, anxiety, depression, all those kinds of things that we've talked about at other hearings -- can easily under certain kinds of circumstances, be easily confused for the Army's description, okay, of personality disorder.    REP. ROE:  I yield back, Mr. Chairman.    REP. FILNER:  Thank you.    On the figures that Mr. Roe referred to, the doubling from 2006 to 2008, and then you said it shrunk by 75 percent, I didn't get the date by which they had shrunk?    MR. BERGER:  2008, sir.    REP. FILNER:  In 2008 it shrank by 75 percent?  Okay.    MR. BERGER:  Yes. Between 2008 and 2009. The annual number of personality disorder cases dropped by 75 percent. Only 260 soldiers were discharged on those grounds in 2009. At the same time, the number of PTSD cases soared.  So.    REP. FILNER:  And how about that -- the other diagnosis that Mr. Kors brought up, the so-called adjustment disorder or pattern of conduct? Do you have those figures?    MR. BERGER:  I don't have those figures with me, sir.    REP. FILNER:  Okay.    Mr. Sullivan, I want to thank you, as usual, for being very specific in your recommendations that, you know, we can look and try to, you know, to deal with those.    I'm just -- I don't have personally a doubt that something is going on here. I just -- it's hard to imagine, but maybe I shouldn't -- maybe I'm too naive -- somebody ordering, you know, disclosures -- I mean diagnoses or changing diagnoses.    I mean, have you seen that happen or do you know if that happened, that, you know, that these changes in the figures somehow became, because of somebody said a policy change, you know, I mean, or did -- I mean, it doesn't just happen.    MR. BERGER:  That's why we're asking the question, sir.    MR. SULLIVAN:  And really what we need, Mr. Chairman, is more transparency from the Department of Defense.  Because when we see the number of personality disorders drop after the hearing, yet the number of adjustment and pattern of misconduct discharges rise after the hearing, it looks as if the DOD is just playing one of those shell games. And that is what we want to make sure is not happening. We want to make sure that service members have their due process rights upheld, because we don't want anybody to be hazed, browbeaten, or, as you use the word tortured into possibly signing a document that gives up some of their VA health care and disability benefits.    MR. BERGER:  Mr. Chairman, in reference to the question you asked a few minutes ago, the -- I can't honestly believe that they reviewed every single one of those 22,600 cases. Okay? They made the statement in public, though, okay, at least spokesperson for the U.S. Army Medical Command said that they did. But there weren't any changes made.    I find that -- I really find that hard to believe.    REP. FILNER:  Can you give -- by the way, is there a more specific subsets of examples of personality disorder? Could I ask what was your personality disorder to the sergeant? And they just noted whatever -- whatever that those initials were. But, I mean, are there more?    MR. BERGER:  There are categories, sir.    REP. FILNER:  Can you give me just some?    MR. BERGER:  Not off the top of my head. It just flew out of my head. I think there's three or four categories of personality disorder.    (Cross talk.)    REP. FILNER:  But I mean, also, based on your testimony, you would expect these to have been noted in a --    MR. BERGER:  Yes.    REP. FILNER:  -- in a pre-physical or pre, you know --    MR. BERGER:  Pre-screening.    REP. FILNER:  In any -- you know, before they are enlisted or volunteer for the service?    MR. BERGER:  Yes, sir.    REP. FILNER:  You would think that they would be noted.    MR. SULLIVAN:  Mr. Chairman, Dr. Roe actually asked a good question, but it could be phrased a little bit better, if I may.    He should ask the military how many potential recruits were actually refused the opportunity to enlist because of a personality disorder. Then you would actually get a better statistic about what's going on. Because if the military suddenly you see an increase or a decrease in rejections for personality disorder, then you can say, well, what's the military doing that's different at the military entrance processing stations, these MEP stations where they do the exam?    REP. FILNER:  Have you seen any of those statistics here?    MR. SULLIVAN:  No I don't -- I don't have them, but that's the kind of question that should be asked.    REP. FILNER:  Okay.    For panel four, it's being asked, I just want people to know.    Okay. Thank you. We'll be -- we may want to look at you again further.    I would ask panel three to come forward.    MR. SULLIVAN:  Thank you, sir.    REP. FILNER:  Thank you for your.    Dr. Debra Draper is the director for health care for the U.S. Government Accountability Office.    You have made several studies, I think, of this issue, and we thank you for what you -- what the GAO does and we welcome your testimony today.    MS. DRAPER:  Chairman Filner, thank you for the opportunity to be here today as you discuss personality disorder separation and the impact on veterans benefits.    DOD policy allows enlisted service members with a personality disorder to be involuntarily separated if the disorder is severe enough that it makes the service member unsuitable for military service.    Those who are separated solely on the basis of a personality disorder are ineligible to receive disability compensation benefits because the disorder is considered to be pre-existing and not a service-connected condition.    Prior to separation, DOD requires the services to comply with three key requirements.    First, a service member must be diagnosed with a personality disorder which interferes with their ability to function in the military.    Second, the service member must receive notification of their impending separation.    And third, the service member must receive formal counseling.    But the bottom line is that the military services have not demonstrated full compliance with DOD's requirements. In my statement today, I plan to first discuss findings and recommendations from the GAO's 2008 report on personality disorder separation. I will then discuss what actions DOD and the military services have taken with regard to our recommendations.    In 2008, we reported that documented compliance with DOD's requirements varied by specific requirement and by military instillation.    For example, in a review of personnel records from four military installations, we found that documented compliance with the diagnosis requirement ranged from 40 to 78 percent and from 40 to 99 percent for formal counseling -- for the formal counseling requirements.    Based on these and other findings, we recommended that DOD direct the military services to develop a system to ensure compliance with the requirements and that DOD monitor the services' compliance.    In August 2008, after our review was completed, DOD clarified its existing requirements and added new requirements, including, for example, requiring that service members with a personality disorder diagnosis be advised that this does not qualify as a disability and requiring corroboration of the disorder for service members who have served in imminent danger pay areas.    In response to our 2008 recommendations, DOD instructed each of the military services to provide compliance reports for each fiscal year 2008 and 2009. The fiscal year 2008 reports indicated that approximately 2,000 enlisted service members were separated that year due to a personality disorder.    Three of the four services did not demonstrate full compliance with any of their separation requirements. None of the services demonstrated full compliance for all the requirements.    And neither the Army nor the Navy reported the number of separations among service members who have served in imminent danger pay areas in accordance with DOD instructions.    Although the fiscal year 2009 compliance reports were due March 31st, 2010, we are unable to comment on them because despite repeated attempts to obtain them, DOD has not yet provided them to us.    In response to our recommendations, DOD also instructed the military services to provide a plan of correction if compliance for any personality disorder separation requirement was less than 90 percent. According to their 2008 fiscal year reports, each service has planned or taken corrective actions to improve compliance.    For example, the Army reported that the Army's Office of the Surgeon General will review all personality disorder separation cases to ensure that each contains the required documentation.    To summarize, the military services have not demonstrated full compliance with DOD's personality disorder separation requirements. Consequently, some service members may be at risk of being inappropriately separated and as a result denied benefits for which they may be eligible. We therefore reiterate the importance of DOD fully implementing GAO's 2008 recommendations.    Mr. Chairman, this concludes my opening remarks. I'm happy to answer any questions.    REP. FILNER:  Thank you, Dr. Draper. Your summary is very clear.    You said -- I'm not sure I'm quoting you exactly -- but the Department of Defense has not provided information post-2008, is that what you're saying?    MS. DRAPER:  Yes. What they had done, they had required the military services to provide compliance reports for each fiscal year, 2008 and 2009. They provided us with the 2008 reports, but we've attempted repeatedly to obtain the 2009 reports and we've been unable -- they've been unable to produce them or give them to us.    REP. FILNER:  What is your legal standing in regard to that? Can you subpoena them? Or do you request them and -- you said repeatedly. Have you notified Congress that they haven't complied?    MS. DRAPER:  Well, it's unclear whether the reports actually exist or they just don't know where they are. They haven't been done. So.    REP. FILNER:  Did you ask them that?    MS. DRAPER:  Well, we did, but no one seems to know where they are.    REP. FILNER:  I mean, do you have any legal authority to compel them to provide those reports? Assuming they exist.    MS. DRAPER:  I mean, we'll have to check into that. We're still -- up until this testimony we were still trying to obtain the -- obtain the reports.    REP. FILNER:  I mean, I assume Congress has that subpoena authority, but we need you to tell us whether you're getting the information.    But you haven't officially told us that you're having a problem with that report?    MS. DRAPER:  Not yet, no.    REP. FILNER:  Okay. All right. Okay. And we do appreciate your -- your -- the work that you're doing and we appreciate your testimony and we'll see -- we'll look at the next panel and see if we need you back.    DR. DRAPER:  Okay. Thank you very much.    REP. FILNER:  Okay. Thank you. Appreciate it.    Panel three is excused.    If panel four will come forward.    Joining us from the Department of Defense is the acting director of Officer/Enlisted Personnel Management, Lernes Hebert, accompanied by Jack Smith -- Dr. Jack Smith -- who is the deputy assistant secretary of defense for clinical and program policy. Major General Gina Farrisee is the director of military personnel management of the Office of the Deputy Chief of Staff, the United States Army, and General Farrisee is accompanied by Colonel Rebecca Porter, who is the chief of behavioral health of the Office of the Surgeon General.    From the VA, we have Dr. Antonette Zeiss -- Antonette Zeiss -- who is the acting deputy chief of patient care services for the Office of Mental Health, and accompanying her is Tom Murphy, director of compensation and pension services. Two, four, six, okay.    And I said, Mr. Hee-bert (prounoucing phonetically), I meant Ay- bear (pronouncing phonetically), is that a better pronunciation? I apologize.    You have prepared testimony, I think all of you, but I would like you to submit those for the records and answer some of the questions that have come up, but I'll leave it to your discretion to how you are going to do that. I would like to -- I would like you to throw away your prepared testimony and answer some of the interesting issues that have been raised, but I'll leave it up to you.    Mr. Hebert?    MR. HEBERT:  Yes, sir. I'll be happy to submit that, although it does answer several of the questions that's come up. If you'll allow me, I'll try and address some of those.    REP. FILNER:  Please. Please.    MR. HEBERT:  For instance, you asked why individuals are accepted with personality disorder discharges. Many times the individuals don't share the information with the -- (inaudible) -- professionals, and if it's not diagnosed at the time of entry, naturally there's no determination that such a diagnosis exists and there is no indication --    REP. FILNER:  They may not tell you they had a broken leg, but you'll find it, won't you?    MR. HEBERT:  We can test for that, sir, and with regard --    REP. FILNER:  I bet you can test for personality disorder.    MR. HEBERT:  Well, I couldn't speak to that but we have someone who can.    REP. FILNER:  You discharge people for it, so you have to have a test for it.    MR. HEBERT:  Well, we rely on medical professionals who are well qualified --    REP. FILNER:  Why don't you do it before they're enlisted?    MR. HEBERT:  We potentially could create some sort of scenario where they would --    REP. FILNER:  But you don't now?    MR. HEBERT:  Well, sir, would you have them serve for some period of time, many times our --    REP. FILNER:  No, I don't want them in it if they have a personality disorder, since you're discharging them. So why don't you figure it out before their in. Since it's a pre-existing condition, it must -- you must -- you could find out about it.    MR. HEBERT:  Sir, it's a behavioral condition --    REP. FILNER:  Do you know how many -- how many do you find -- how many -- how many people are diagnosed with personality disorder and are rejected for enlistment or volunteer service?    MR. HEBERT:  I do not, sir.    REP. FILNER:  Do we have those records?    MR. HEBERT:  I suspect we do not, sir. But I will look into it.    REP. FILNER:  You mean to say that -- you can't tell me -- can you tell me how many people have applied for volunteer, or have volunteered for service in a given year, and how many people were rejected? You can't tell me that?    MR. HEBERT:  Yes, sir, I can tell you that.    REP. FILNER:  Then you must be able to tell me why they were rejected.    MR. HEBERT:  You asked whether or not we had the records. We do not presently have the records. We will take that question for the record and go back and research it and provide the committee --    REP. FILNER:  I assume you have this information. I mean, not that you have it here, but you must have that information.    MR. HEBERT:  We do have the information on a number of individuals who were rejected from enlisting, yes, sir.    REP. FILNER:  All right. You can continue.    MR. HEBERT:  Yes, sir.    The question was raised with regard to how many personality discharges have occurred since 2007. In 2008, we record 2,903. In 2009, 1,426.    REP. FILNER:  The first one was 903?    MR. HEBERT:  Yes, sir.    REP. FILNER:  In 2000 and -- it was 2008, right?    MR. HEBERT:  Yes, sir.    REP. FILNER:  And 2009 was what?    MR. HEBERT:  2009 was 1,426, and year to date 2010 is 650.    REP. FILNER:  Is that more or less than happened from 2000-2007? I mean, do you have any sense of whether that's more or less than from 2000 to 2007?    MR. HEBERT:  It is less. It's a continuing declining trend and we see that declining trend across all four services.    REP. FILNER:  Have you -- do you know why? Have you accounted for that?    MR. HEBERT:  We have no direct correlation, sir, but we would attribute the more rigorous screening process that we're doing for PTSD and TBI as contributing to that trend.    REP. FILNER:  And do you have any problem with the figures that I think either Dr. Draper or Mr. Sullivan said, that there was a shrinkage by 70 percent -- 75 percent in 2009 from previous years? I mean, is that accurate?    MR. HEBERT:  I'm not -- there was a shrinkage. It wasn't 75 percent. I'm not sure which figures, whether that was specific to the Army or they were talking --    REP. FILNER:  We'll, try to check that.    MR. HEBERT:  Yes, sir.    REP. FILNER:  All right. But it looks to me, if you have 3,000 in those three years and 23,000 in seven years; it's a big -- big drop. Okay.    MR. HEBERT:  Yes, sir.    REP. FILNER:  I'm sorry; go ahead if you have any --    MR. HEBERT:  And additionally I believe you asked what was the incidence of personality disorder in the population versus the Department of Defense. We don't have that information with us. We will be glad to provide that for you.    Dr. Zeiss -- (inaudible)?    REP. FILNER:  Who did the -- the report which -- I mean which of you is responsible for the report of the -- the review that was required of the previous 23,600? Who could I ask that about when it's their turn?    MR. HEBERT:  Yes, sir, I believe that was -- I'm not sure, sir.    REP. FILNER:  You didn't do that?    MR. HEBERT:  No, sir.    REP. FILNER:  Does it sound reasonable to you that out of, I don't know, 23,600 of anything that not one mistake was made by anybody? I mean I don't care if it's, you know, two plus two is four, somebody's going to make a mistake somewhere. Do you find that a little bit uncredible? Even incredible?    MR. HEBERT:  Without the information with regard to the review --    REP. FILNER:  Does anybody here have responsibility for that?    Please?    COL. PORTER:  Sir, if I may. I'm from the Army Surgeon General's Office. And my understanding is that rather than the 20-some thousand records that's being quoted here, what in fact was reviewed in the Army Surgeon General's Office were -- it amounted to approximately 600 records, and those were individuals who were separated with a personality disorder diagnosis who had been deployed to an imminent danger pay area.    And from -- in those years that the review was conducted it was less than 600 people. The review was conducted by psychiatrists and psychologists in the Army who were brought to the Surgeon General's Office to do the review, and their findings were that they did not see any evidence that a misdiagnosis had occurred.    REP. FILNER:  They didn't do any interviews of any of the 600 people?    COL. PORTER:  No, sir, they did not.    REP. FILNER:  That doesn't sound like a good review to me. I mean, you're reviewing -- somebody -- Mr. Buyer complained about hearsay. I mean this is see-say. I mean somebody reads the report, and somebody -- somebody has written a report, somebody else sees it, and somebody reviews it. I mean, that doesn't sound like a real investigation to me.    Is there a word like see-say? If you have hearsay I guess you can have see-say. I invented new word -- (inaudible). Use that. (Laughter.) I'm sorry. I mean it just doesn't sound appropriate to me. I'm just a layman, what do I know? But how do you know that just, I mean, yes, there's no evidence that it's wrong because the guy wrote a diagnosis. Did he give -- did the doctor give a reason for the diagnosis? And was that reason reviewed and was that checked with the actual soldier who was reviewed in this way?    I mean it just doesn't sound reasonable to me.    COL. PORTER:  Sir, I think the corrective action that we've taken and that we continue to take right now is that when we review those records, and they are sent to the Surgeon General's Office now before they're endorsed, we ensure that not only is there a diagnosis written down, but that the documentation for that and the rationale that the provider used to come to the diagnosis are very clear in the record. And if we don't see that, then we ask for more information.    REP. FILNER:  I mean, are you implying -- are you telling me that that wasn't done before with the 23,000, that they weren't required to do that, or didn't do it, or whatever?    COL. PORTER:  I think -- I think, sir, that before the recordkeeping was not as clear as it could have been. And now we --    REP. FILNER:  Well, that just begs then for -- if you were directed to investigate whether they were sound or not and you found out that not very -- (inaudible) -- you know, that there was no real rationale, that -- it seems to me you should go back and say, "Doctor, what was the rationale?" and then check that with the patient. I mean it just looks like you reviewed it, you found that there was no rationale. Wow. Seems to me I would check the records of all 23,600 and say, "Hey, soldier, we didn't provide any rationale, we better look at you again."  I mean, why didn't you do that?    COL. PORTER:  I'm not sure I understand the question, sir. Why didn't we go and find --    REP. FILNER:  If you are saying that based on your review of those 600 files, your forward looking thing was -- and now you require a far more specific rationale for that diagnosis, which leads me to think that that didn't happen on the first 600, or the 22,600. And if that didn't happen, and if you were required to review the accuracy of this, it would seem to me that would force you to go back to the doctor and maybe the patient and say what was the specific rationale on which you based this diagnosis.    I mean, I'm just a layman here, but it seems to me that -- I mean look, you're concerned with your soldiers. I'm concerned with your soldiers. If you're really concerned with them, find out why they're being diagnosed in this way and you found out that we didn't have any real accurate diagnosis. So wouldn't you want to go back and try to correct the record?    MR. HEBERT:  Sir, if I may, what we are doing is reaching out to our veterans who have separated since 9/11, who have been characterized with separation of personality disorder, who had previously deployed as part of their service, and we're reaching out to them to inform them of what options are available to them if they consider their discharge mischaracterized and how to access VA benefits with respect to getting screening for PTSD.    REP. FILNER:  You've notified or tried to notify all 22,600 --    (Cross talk.)    REP. FILNER:  -- 1,426 and 650?    MR. HEBERT:  That's not my number, sir, but we are notifying every veteran who separated since 9/11 who had a separation characterized as personality disorder who had previously deployed to make sure that they have access.    (Cross talk.)    REP. FILNER:  -- you're not saying come back and let us relook at you and see if we made the diagnosis correct, are you?    MR. HEBERT:  No, sir. We're asking them if they believe they have -- their separation was mischaracterized or if they believe that they have symptoms of PTSD or traumatic brain injuries that they seek help, and that we're giving them the instructions, if you will.    (Cross talk.)    REP. FILNER:  Can you give me a copy of that outreach, whatever it was, a letter or whatever you're doing?    MR. HEBERT:  Yes, sir.    REP. FILNER:  By the way, are you able to get in touch with everybody? I mean are the letters coming back "no sufficient address"?    MR. HEBERT:  As a result of the inputs from the services with respect to the report that the GAO brought up, that's what's driving this outreach.  And we're just in the initial stages of it and --    REP. FILNER:  Now your initial stages has actually started. You said you're notifying everybody. So how many have you notified?    MR. HEBERT:  We will notify everybody.    REP. FILNER:  But how many have you notified now?    MR. HEBERT:  We have notified no one.    REP. FILNER:  No one?    MR. HEBERT:  Sir, the report came in --    REP. FILNER:  I mean, look, look, look, look. You started -- you know, I'm just pursuing some questions because I think this way, but if I didn't pursue -- you led me to believe -- and I can ask the recorder to read what your words were -- that you already notified everybody. Anybody -- (inaudible)? I mean, that's what I heard, that you have notified everybody. Now you're saying you haven't even started the notification process. So you haven't started it?    MS. HEBERT:  No, sir.    REP. FILNER:  When will you do this?    MR. HEBERT:  We are in the process of -- of --    REP. FILNER:  How long does that process take? Since you're making me ask these stupid questions because you're -- you're -- you know, I don't know whether you go to school to learn this or it's part of your personality disorder, but -- oh, excuse me, I couldn't -- I couldn't diagnose that so quickly.    I mean, you're not telling me anything.    I have to ask what your words mean. So when are you going to do this?    MR. HEBERT:  We're doing it now, sir.    REP. FILNER:  When will you notify all 22,600 plus 903 plus 1,426 plus 650?    MR. HEBERT:  Over the upcoming months we will notify everyone that we have contact information on.    REP. FILNER:  You guys are -- I think all of you should be examined. I mean, I think all the civilians should be examined for personality disorder. Man, I'd discharge half of you, I think, but that's only me. I'm just a layman here.    But you're talking, you know, we're supposed to be talking English to each other. We're trying to get some -- and you're not helping me very much, and it sounds to me you don't want to help me, and, you know, you're playing with words and you're playing with stuff and, I mean, you don't have records here, you know what we're going to ask, it's all been published and it's all been around. You just don't have the information.    You got any other nuggets for me?    MR. HEBERT:  Mr. Chairman, we are committed to our veterans, our serving and our former members. And as a department, you're looking at a team here that represents a much larger team that works together on a daily basis to try and make sure that accurate diagnosis occur, that accurate separation characterizations occur, and that our members most importantly are taken care of with the respect they deserve.    REP. FILNER:  Given the fact that you had 23,600 discharges in seven years or whatever --    MR. HEBERT:  Yes, sir.    REP. FILNER:  -- does that -- wouldn't that lead you to believe that your intake interview was -- has to be better?  I mean, have you changed that? If you're taking people that have personality disorder and you find out about them after they've gone through combat and after they've had severe injuries and after they've had blast concussions, then you find out they have personality disorders, doesn't that lead to some conclusion? I mean, why did you take them in? I can't figure that out?    DR. SMITH:  Sir, if I could comment.    The screening process is certainly one that presents some difficulties. It does rely upon self-volunteered information.    In many cases, people with personality disorders may never have been diagnosed. There have been addition of additional mental health questions to the screening questionnaire, but, again, that hasn't identified a great number of people. And it's usually in the performance of duties that problems come to light and then can be more thoroughly evaluated by medical personnel after they've been accessioned.    REP. FILNER:  After they get clumps of shrapnel in their leg, then you'll figure out they have a personality disorder?    You're not giving me a lot of confidence that you know what the hell you're doing. I mean -- I mean, I can't figure out how you screen the beginning and then all of a sudden all these people you found -- and I don't know how you find them out then.    I mean, Mr. Kors wrote about that this is sort of on purpose and this is -- this is designed to save money. You haven't given me any reason not to accept that conclusion.    DR. SMITH:  The people with -- who are eventually diagnosed with personality disorder ordinarily are brought to light through difficulties adjusting to military life. And most -- most of those will occur early in their service and have difficulties adjusting to the requirements that are placed --    REP. FILNER:  And how many of those have you found since 2001?    DR. SMITH:  I believe the numbers that Mr. Hebert quoted were -- were inclusive of those who were early in service. I think that the percentages of people who have served in an imminent danger pay area are a small percentage of those totals if I'm correct about that --    MR. HEBERT:  That's correct.    REP. FILNER:  So it's a small percentage of the total, is what you just said?    DR. SMITH:  The number of people who have served in an imminent danger pay zone who are subsequently diagnosed with personality disorder are small.    REP. FILNER:  No. Okay. But what percentage -- you said you find out about them early in their military service. So what percent of the discharges that you find out, I don't know, within a year, versus those that occur after they've been, say, in combat? I mean, does this 23,600 figure include those earlier -- earlier discharges?    DR. SMITH:  I believe that's correct, yes, sir.    REP. FILNER:  Okay. So what percentage is which? Do you know?    MR. HEBERT:  We can provide those numbers for you, sir.    REP. FILNER:  Well, all I'm asking, because, you know, apparently I don't hear very well because your -- your words seem to mean something else after you say them.    But you are trying to justify the fact that you did not find them earlier by saying, oh, you'll find them, say, I don't know, during boot camp or doing something. And so it sounds to me that you're saying, "Oh, we find them before they become a real problem for our, you know, combat." So I just want to know the percentage of it.    DR. SMITH:  No, sir, I didn't say that we find them before -- at any particular time. I think that people who are having difficulties adjusting to military life are oftentimes referred for evaluation, and that may occur very early in their time. It may -- it may be at some later point in their service. That's rather hard to predict.    REP. FILNER:  All right. The next person on the panel, please?    GEN. FARRISEE:  Mr. Chairman, I will submit my comments for the record and attempt to answer any questions you have.    REP. FILNER:  Okay. Tell me how -- what your sphere is different than their sphere so I know what kind of questions to ask.    GEN. FARRISEE:  Sir, I am from the deputy chief of staff of personnel in the Army and I am working in the policy area.    REP. FILNER:  Okay. You're aware of the review that was done of the 600 now it turns out?    GEN. FARRISEE:  Yes, Mr. Chairman, I knew that they did do a review of those records. I did not know the conclusions until this week.    REP. FILNER:  I'm sorry?    GEN. FARRISEE:  I did not know the conclusion to the review until this week.    REP. FILNER:  When was that done?    COL. PORTER:  Mr. Chairman that review was done in 2007 and 2008.    REP. FILNER:  It takes a while for the Army to figure out what's going on, huh? You just found out about it, let's see, now three years later? And this is your sphere of responsibility?    GEN. FARRISEE:  No, sir, not the results for the record review.    REP. FILNER:  That's not your sphere of responsibility?    GEN. FARRISEE:  No, sir.    REP. FILNER:  So you didn't care what they found out, huh? You knew this was taking place, I assume?    GEN. FARRISEE:  Sir, I do care. I knew it was taking place. I did not hear the results and I probably should have heard the results, yes, sir.    REP. FILNER:  Okay. Did my sort of, again, layman critique of the way it was done have any validity in your view? Like you didn't talk to the soldiers. You found out that there was no specific rationale so you didn't go back to the doctors; you only had a small sample to begin with. Was that -- was any of that valid?    GEN. FARRISEE:  Mr. Chairman, as far as the small sample, the only sample that we took was going to be soldiers who had been deployed, who had gone to an imminent pay danger area. So it was specifically only for those soldiers who had deployed that they would do a relook at those records. I did not know that they did not speak to anyone until this week. I was not told how they were going to do the review. I believe that the Surgeon General's Office would in fact do that review again of those records and do it properly.    REP. FILNER:  I mean, but you heard some of the testimony which talked about physical injury, and then that was somehow related to personality disorder. Does that -- could that happen?    GEN. FARRISEE:  Mr. Chairman, I can't answer that question. The first time I've ever heard that was when I saw Mr. Kors' article. I have never heard that before.    DR. SMITH:  Sir, if I could comment on that. I think -- I think that it's possible for someone who has a personality disorder to have other diagnoses. So someone who has broken a leg may also have a personality disorder, but there's certainly not a connection between those two diagnoses or a causality, which I think was suggested in panel one.    REP. FILNER:  Well, but if all 600 that you're looking at, I mean, their personality disorder seemed to come to light after a major physical injury, or major psychological injury --    DR. SMITH:  I'm not sure -- I'm not sure that it did come to light, sir. I think the review that the Army conducted was of people who were diagnosed with personality disorder and had been separated administratively for personality disorder.    REP. FILNER:  Yes, but I asked you what percentage of that was based on their common combat versus just happened to -- somebody -- some officer saw something. I asked you and you said you didn't know how many of percentage of that? It sounds to me like it -- when these people had -- had physical injury that may have led to discharge, that's when you found out the personality disorder.    DR. SMITH:  No, sir, I don't believe that's correct. I think that the 600 cases that were reviewed by the Army were all people who had been deployed to an imminent danger pay zone, may not have had any other physical diagnoses or injuries. There may have been some, but --    REP. FILNER:  Do you know how many of each?    DR. SMITH:  I do not know -    REP. FILNER:  So how can you even tell me that -- I asked you guys for figures, you don't have them, but you're making judgments based on your sense of the figures. So --    DR. SMITH:  The review of the records was for people separated for personality disorder.    FILNER:  Right, but you can't tell me, because I just asked you, how many of those had physical injury which brought that diagnosis to light? You said not very many, or you said -- (inaudible) -- to be true, but you don't -- you're not giving me any numbers.    DR. SMITH:  Personality disorders would not ordinarily come to light as a result of a physical injury.    REP. FILNER:  But that's the whole point that we're having this hearing for. They get discharged, not for PTSD or TBI or shrapnel in their thigh, they get discharged for personality disorder. So they came in for -- they only were diagnosed because they were getting treatment for these other things, it sounded to me.    Mr. Kors, is that right or wrong?    DR. SMITH:  I'm not sure that I could say that that's accurate, sir.    REP. FILNER:  Well, but you can only say it's not if you give me the figures and you don't have to tell you can't give me the figures. So until you give them to me, I can't --    DR. SMITH:  We'd have to -- we'd have to take that question for the record, sir.    REP. FILNER:  Well, I'd like you to do that.    Who -- who would be responsible, General, with -- I mean, Sergeant Luther's report of what I call torture, could that happen in the Army and was it ever investigated and did anybody ever, the people who were accused of doing this ever -- there are pictures of the thing, there are -- there seems to be witnesses. Was that ever investigated?    GEN. FARRISEE:  Mr. Chairman, to my knowledge it was not. When it first came out in the media it was referred to Fort Hood, and I will have to follow up with them to find if there was any investigation.    REP. FILNER:  Man, if I were you, I would have jumped, we can't let that happen in the Army, and if it's true, somebody's got to be punished, and if it's not true, that's got to be known, too.    GEN. FARRISEE:  Yes, Mr. Chairman.    REP. FILNER:  Some people are making these charges in public session here where they're sworn to tell the truth, they've been in the newspaper, and surely you'd be concerned if the Army was accused of torturing its own soldiers, wouldn't you?    GEN. FARRISEE:  Yes, Mr. Chairman.    REP. FILNER:  Would you find out if there was any investigation for me?    GEN. FARRISEE:  We will take that question for the record, yes, Mr. Chairman.    REP. FILNER:  Thank you so much.    I'm sorry, who is the next victim, I mean the next -- (inaudible)?    MS. ZEISS:  Well, I will go next, and I represent VA, so happy to make just a couple of points since the issues for VA have not been as much in focus. So I won't go through my full written testimony or oral testimony, but will just want to make a couple of points and then happy to answer whatever questions you have.    REP. FILNER:  Thank you.    MS. ZEISS:  First of all, I would just like to say that my oral testimony did go over the diagnostic criteria for personality disorders.    There are three clusters with 10 different personality diagnoses, and Dr. Berger has really gone through the basics of that, so we need not --    REP. FILNER:  You didn't have any problem with his -- his testimony then?    MS. ZEISS:  No.    REP. FILNER:  Okay. So when I read your testimony it's again underlined from Dr. Draper, I guess, enduring pattern of inner experience, so it's enduring?    MS. ZEISS:  Yes.    REP. FILNER:  It's manifested in both cognition, affect, interpersonal functioning, impulse control.    Would you expect that all to be diagnosed, by the way, by the military's intake -- intake testing of these guys?    MS. ZEISS:  I can't comment on how thorough the intake testing would be and whether they could reach a diagnosis.    The point, second point I'd like to make is that eligible veterans can get the health care they need from VA, whatever their mental health or physical health diagnosis and whatever their diagnosis when they leave the military assuming that they are eligible, and that's based on two factors, the character of the discharge and the completion of service.    If they enter VA care, they will be routinely screened on an early visit to primary care for PTSD, for depression, for problem drinking, for TBI, for military sexual trauma. And if any of those screens are positive, there will be a full evaluation and a full diagnostic process to guide health care decisions.    In addition, veterans who seek compensation and benefits can do so on the basis of whatever diagnoses they choose to present while information from prior experiences may be part of the C-file that comes to the VHA clinical examiner, they will do a full clinical examination based on DSM-IV-TR criteria to determine whether or not that is an appropriate diagnosis.    The fact that someone may have been separated for a personality disorder diagnosis would not be compelling information. The information would really come from the clinical exam that would be done by the VHA doctoral-level psychologist or psychiatrist.    So we are committed to providing care to eligible veterans. We are eager for veterans, whatever their diagnoses, when they're discharged to know about their ability to access VA care. We have tried to get that word out. We have contacted all OEF/OIF veterans who had not sought VA care to let them know about their eligibility and about how to do so. So we are eager to provide --    REP. FILNER:  You have contacted, or are you in the process --    MS. ZEISS:  We have contacted.    REP. FILNER:  Thank you.    MS. ZEISS:  That was a couple of years ago.    REP. FILNER:  Oh, it can be done, huh?    MS. ZEISS:  And, you know, we certainly want to cooperate and look forward to potentially receiving some additional veterans who seek care with us after the outreach the Department of Defense plans.    REP. FILNER:  Are you aware of -- of the situation that we -- that this is a hearing that people who were discharged for personality disorder feel it was wrong and -- and want to get -- want to get health care for their service connected?  I mean, is that common?  I mean, do you have -- do you know how many people would that be in, or basically that your -- I don't know if your diagnosis would be counter to that, but it's a different situation, I guess.    But are there people who have come in diagnosed with personality disorder that you haven't found had personality disorder, or you didn't diagnose in that way? Do we know that or not?    MS. ZEISS:  We know that of veterans who have sought VA care at this point cumulatively since 2002, 7,348 have received a personality disorder diagnosis. They may have additional diagnoses, but there -- that's about 1.3 percent of those veterans who have come to seek VA care. And that's a diagnosis given by a VA clinician.    REP. FILNER:  But do you know how many --    MS. ZEISS:  We are --    REP. FILNER:  -- how many people came in with a personality disorder diagnosis from the military and didn't receive that diagnosis from the VA?    MS. ZEISS:  I don't have those numbers.    REP. FILNER:  Would we know that? I mean, do we -- would we keep such information?    MS. ZEISS:  We can certainly go back to public health and environmental hazards who get the separation file from the Department of Defense and see whether there's information in that file about what the discharge diagnoses were. Again, we seek to establish our own diagnoses, but we can see -- you know, I can certainly try to get that information.    I would add an additional --    REP. FILNER:  I'm going to let you add, but the 1 percent -- 1 percent plus figure was 1 percent of what? Of all the people who come to you in VA?    MS. ZEISS:  1.3 percent of those OEF/OIF veterans who have sought care in VA.    REP. FILNER:  Only 1 percent have had -- diagnosed with PTSD -- I mean with personality disorder?    MS. ZEISS:  1.3 percent.    The other thing that we're very aware of is that Congress has given vet centers the legal authority to work with veterans who want guidance to appeal their discharge status. And they certainly take that charge seriously and do work with veterans who want to return to the Department of Defense with additional information and attempt to see whether the discharge status can be changed.    REP. FILNER:  Do we know how many of them have done that yet?    MS. ZEISS:  Vet centers take very --    REP. FILNER:  Oh, this is the vet center?    MS. ZEISS:  It's vet centers. And we work very collaboratively with them, but they don't enter data in the electronic medical records, as you know.    REP. FILNER:  I understand that.    MS. ZEISS:  And they take very seriously their confidentiality. So we won't get specific data from them, but --    REP. FILNER:  But the military should know who has appealed their case, I assume? I assume for -- you know, they want to change their -- and how many of those have come to you guys? Specifically for personality disorder?    MS. HEBERT:  We'll take that for the --    REP. FILNER:  You don't have that either, okay.    Does anybody, you know, want to correct anything I've said or take issue with -- I mean you have a chance to say anything you want before I let you go, about this issue.    How should we be looking at it? What would help us and help you do your job better?    MS. ZEISS:  The only thing I would add from the VA perspective is that PTSD in particular is a diagnosis that we know can have late onset, so we don't assume in VA if we make a different diagnosis than the diagnosis that was made in the Department of Defense that it was necessarily an incorrect diagnosis. They were working with whatever information they had at the time, and people -- people are dynamic, they evolve, change, and PTSD can have late onset.    That would not be as true, obviously, for TBI and for some other disorders.    So we want to be clear that while we want to do our own diagnoses, we are working with a veteran as they are when they appear to us at VA.    REP. FILNER:  I understand that, but if something like 98 percent of what you work with, you differed with the military, it would tell us something. Not that they were wrong, but you found out in every case that they seemed to make the wrong diagnosis or the different diagnosis.    Any -- anybody from the Army or Defense Department?    COL. PORTER:  Mr. Chairman, I want to express that we sincerely appreciate the concern that you have for both the serving members and the veterans.    I think to speak to some of the GAO observations that perhaps the Army wasn't complying with the directives that had gone out, what I would say is that in the Army we have started within the OTSG, or the Surgeon General's Office, we've started an inspection program where we go out and we pull records and we look at what's happening at the ground treatment facilities just to make sure that they're not ignoring the directives.    The other thing that we have in the works, it's not done yet but it's being done, it's on its way to the surgeon general for approval, is stricter guidelines for any kind of separation -- administrative separation that has a mental health diagnosis in it.    So whether it's a personality disorder, an adjustment disorder, PTSD, any of those will have to come to the Surgeon General's Office for review so that we can -- we can have an oversight of any of those. And we're requiring the regional medical commanders to acknowledge receipt of that guidance so that there isn't any more people saying we didn't know.  That's all I have, sir.    REP. FILNER:  I think Dr. Draper mentioned that she was having trouble getting some documents for 2009, I think? Do you know anything about that?    COL. PORTER:  I don't know anything about it, but we'll certainly get what we can --    REP. FILNER:  Okay. You'll be glad to help us find the right documents.    Thank you.    Department of Defense, anybody want to say something?    MR. HEBERT:  Sir --    REP. FILNER:  I'll give you the last word.    MR. HEBERT:  Mr. Chairman, if your question to -- to the department is whether or not we're satisfied with the progress we've made, the answer is no. Can we do more? Yes. Will we do more? Absolutely.    Admittedly, the amount of time we've had since 2007 to develop a full body of knowledge about the complexities of this issue -- I mean, before you see the medical community, you see the human resource community, and I will tell you our legal communities have been arm-in- arm about this as well.    And together we have forged a very structured, very rigorous screening process to ensure that no veteran leaves from active service without having been properly screened and diagnosed to the extent that it is possible.    Beyond that, we are working with our partners in the VA to make sure that anyone who hasn't passed through those screening process will be identified and will get the proper care and we'll continue to do that. And while we have not begun that fight, we will continue to endeavor.    REP. FILNER:  When you heard the story of Sergeant Luther about this closet, I mean --    MR. HEBERT:  Yes, sir.    REP. FILNER:  -- does anybody in the Department of Defense have authority or responsibility to investigate that kind of charge?    MR. HEBERT:  Allegations of misconduct are generally referred to the Inspector General's Office, yes, sir.    REP. FILNER:  And who -- you just heard that charge, would you refer it or do I have to do it?    MR. HEBERT:  We'll look into it, sir.    REP. FILNER:  Thank you. All right. Well, I appreciate your testimony. You know, I sound a little frustrated and upset only because I am, but it just seems to me we have some pretty -- pretty significant allegations here and it just doesn't sound like we have the information or testimony to allay my fears or my -- my sense that they're right.    So if you give me the answers to the questions that you said you would, I'll get a better understanding and appreciate that. So thank you for your testimony. Panel four is excused.    I'd just like Mr. Kors, if you can return for a second?  I mean I see you as a -- not a person of hearsay, as was stated, but as someone who really understands this issue and is trying to do the best for our soldiers.    What questions would you -- or do you have any response to some of the testimony you heard since you testified this morning or what questions we should ask these panels?    MR. KORS:  I do, yes, about the hearsay, I think they'd let me return my military reporters and editors award if that -- if that were the case.    REP. FILNER:  Thank you.    MR. KORS:  Yes, first of all, about the VA looking at cases in which a soldier clearly did not have personality disorder but were discharged for that, finding that out would take about 30 seconds. When the soldier was called in for VA medical screening they'd say, "Hey, bring your discharge papers." Every soldier has them, they bring them in, on the discharge paper it would say discharged for personality disorder. Now they'd know who they got there.    REP. FILNER:  Is Dr. Zeiss still back there? I mean, do we have -- so I had asked you how many people who were discharged for PTSD -- I mean for personality disorder -- that you didn't find that. I don't think you answered me, but can we figure that out?    MR. KORS:  I think --    REP. FILNER:  Let me just ask her for a second.    I mean, do we have that information?    MS. ZEISS:  (Off mike.)    REP. FILNER:  Okay. Thank you, sir -- thank you, ma'am.    MR. KORS:  And then of course in those cases the Department of Defense remains firm in its decision with Sergeant Luther.    The VA came to a radically different conclusion, said severe traumatic brain injury, but yet a few weeks ago he got a letter for his appeal for his discharge and they said:  Yes, the VA came to that conclusion, but we're sticking with ours.    And you see that over and over in the rare few soldiers who were discharged with personality disorder and know that they can attend VA.    So many of the soldiers we're talking about here are soldiers who don't even know they can enter VA's doors because of this discharge.    And I think it goes well beyond money, that's another important factor here. So many of these soldiers come to me, they say, this discharge is like a scarlet letter they just can't wash off. In today's job economy can you imagine going into a potential employer and handing them a paper saying you're mentally ill? You're just not going to get that job. And so that's how you end up with so many of these soldiers, not just without benefits, but also then broke and then homeless.    REP. FILNER:  The issue you raised, of course is -- I mean all the witnesses we've had since you -- since your panel talk about the law or the regulations, but you're saying the actual conditions, if somebody is told they get no benefits, they don't distinguish between the VA, DOD or this or when, right? I mean, that's --    REP. KORS:  Exactly. They're told they can get no benefits. They don't realize they can get a fresh review at the VA.    REP. FILNER:  And I notice -- is Mr. Hebert still here?    MR. HEBERT:  (Off mike.)    REP. FILNER:  That will be clear in the letter that you now are going to go out to those 23,000 right?    MR. HEBERT:  (Off mike.)    REP. FILNER:  I thought so. Thank you.    (Cross talk.)    MR. KORS:  -- you know, had a dose of comedy there. This idea of how do you find out whether those 22,600 soldiers had pre-existing conditions, well, that's where not interviewing anybody comes into play. If they made a single phone call to a single one of those families, or their doctors, they -- all of them would say this is ridiculous. This soldier has been perfectly healthy, that's why he won 22 honors and was able to serve a dozen years.    So by just dealing with the papers they had produced, they're just recycling their same information over and over. I think about the earlier review done by the Army Surgeon General, Gale Pollock. She said that they had done a five-month thoughtful and thorough review, but with a touch more reporting I thought that in that case, again, they did not interview a single person. All they did was go back to one of the doctors who created the false diagnoses and said, "Hey, did you get it right the first time?" The doctor said, "Yes, yes, I did," and they shut down the review at that point. They even -- you have to have a dark sense of comedy to report on this stuff -- they sent a letter --    REP. FILNER:  You've come to the right committee.    MR. KORS:  They sent a letter out saying that they had additionally reviewed a stack of hundreds of cases out of Fort Carson, the last four years of personality disorder discharges, and realized that -- and came to the conclusion that all of those soldiers were also properly diagnosed, but accidentally one of the surgeon general's staff sent out an e-mail to a fellow military reporter of mine saying, "Hey, we couldn't even find those cases," and the internal reply was, "It's okay, just say that they were properly diagnosed, even if we couldn't locate them."    Ten minutes later the e-mail to that reporter came and said, "Oops, we shouldn't have sent that to you, please ignore." She went ahead and forwarded it to me so that I could see what was going on.    But I contacted the Surgeon General's Office at that point and said, "How did you know that those four years of cases were properly diagnosed when you couldn't even locate them?" and the reply came that they could not answer that question.    REP. FILNER:  Well, again, I want to thank you and many of the soldiers you have interviewed who have gone on the record. Very painful kinds of things to talk about, I know, especially in public. I mean you've opened up something that we need to know about. As you saw, I'm not convinced by the kind of testimony we had that there's not an issue there. And we have to figure out exactly how to get to it.    MR. KORS:  Yes, I mean this is not an example of soldiers slipping through the cracks. When you have soldiers who are wounded and discharged with this, the purpose of this discharge is to get them out the side door.    And again, it's not just money, I think about the PR factor as well. You know, everyone knows about the 5,670 who are dead from Iraq and Afghanistan and the 91,000 who are officially wounded, but the Rand Corporation, an independent agency, looked at this and found that over 400,000 soldiers from these wars were suffering from traumatic brain injury.    By giving those soldiers personality disorder discharges, you're essentially sliding them out the side door and keeping them off the books and records of the wounded.    REP. FILNER:  I'll give you another statistic, and you have the official casualty count that you recited there.  And my sense, and I may not have the exact figures, but it's certainly near, almost a million veterans of these wars have come to the VA for help. A million versus, I thought it was 45,000 reported wounded -- it's not a rounding error. This is a deliberate attempt to -- not to let us know what's going on in the battles.    MR. KORS:  And these aren't just numbers. They're not 1 percent. We're talking about 22,000 shattered families who, first, they have to deal with the wounds from the war and now they have to deal with the devastation of no benefits, no long-term medical care. And the demand that they give back a chunk of their signing bonus just immediately drives so many of these families into debt if they already weren't there.    REP. FILNER:  Well, again, I appreciate the service you're rendering to our country and look forward to trying to see if we can help all of these folks.    MR. KORS:  Thank you.    REP. FILNER:  Thank you so much. This hearing is adjourned.