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Madigan psychiatrist: PTSD diagnoses were fixed at Walter Reed

Post by Adam Ashton / The News Tribune on March 5, 2012 at 10:46 am with 13 Comments »
March 5, 2012 5:37 pm

In her resignation letter, Madigan Army Medical Center forensic psychiatrist Juliana Ellis-Billingsley wrote that the Army’s top behavioral health officer misled Madigan leaders about the results of an investigation into post-traumatic stress diagnoses at the hospital south of Tacoma.

Ellis-Billingsley wrote that Col. Rebecca Porter in early February told Madigan leaders that forensic psychiatrists at Walter Reed Military Medical Center had upheld the first 12 Madigan diagnoses they reviewed among a group of 14 soldiers who contested the behavioral health diagnoses they received from Madigan.

Three weeks later, Porter visited Madigan to deliver the results of the Walter Reed reviews to the soldiers themselves. They learned that Walter Reed overturned six Madigan diagnoses, deciding that those soldiers suffered from PTSD. In eight other cases, Walter Reed agreed with Madigan in diagnosing soldiers with conditions other than PTSD.

Madigan commander Col. Dallas Homas reportedly received the first news from Col. Porter at an Army medical health conference in Washington, D.C. Homas declined to comment today on Ellis-Billingsley’s letter.

Ellis-Billingsley wrote that Homas returned from Washington, D.C., and delivered what appeared to be good news to the Madigan psychiatrists.

“Each day we awaited the release of the information,” Ellis-Billingsley wrote. “Then on 18 February 2012 Col. Homas was administratively relieved and Col. (Mike) Heimall, a medical service officer, was named the interim commander. On 22 February 2012, we met with Col. Heimall and Col. (Karen) O’Brien. Col. Heimall announced that Walter Reed forensics concurred with the diagnoses on only 8 of 14 cases.

“It became patently clear to me that some force above Western Region (Medical Command) came to bear on Walter Reed forensics and they changed their diagnoses. This is professionally unethical. It is now my opinion that all the investigations are a charade as the outcome has been predetermined. Forces will come to bear on the investigators to meet political expediency.”

This is the question I asked Army Medical Command last week about Ellis-Billingsley’s letter:

“I have a resignation letter from a Madigan forensic psychologist. It says Col. Porter from Medical Command at early February’s MHS conference advised Madigan leaders that the Walter Reed reviews supported Madigan conclusions in 12 of 14 cases. This psychologist seems to believe those results were changed for political reasons. ‘It is now my opinion that all the investigations are a charade as the outcome has been predetermined,’ the psychologist wrote. Was Col. Porter speaking too soon? Will there be an investigation into the Walter Reed diagnoses to see if they were influenced for political reasons?”

This is the answer I received:

“Walter Reed National Military Medical Center is not an Army medical facility but a joint medical facility under the operational control of Joint Task Force Capital Medicine.  The Army brought no undue influence or pressure to bear on Walter Reed to produce any particular results in these re-evaluations. Because Walter Reed is not an Army facility but a joint facility, it was well-placed to provide an unbiased look at these cases. We are aware of no particular influence brought to bear from any quarter on Walter Reed in this matter.”

Leave a comment Comments → 13
  1. serendipity says:

    What a racket our government has going to slaughter our young and deprive them of care afterwards. Everyone, unless the war is warranted (and what did Iraq do to us really? And now we send in our miltary contractors to rebuild everything we blew up and they are paid 10K a month). Everyone, refuse to enlist. Just refuse. The government does not care about our young, they just want to slaughter them for very low pay. Shame on the USA. Seriously.

  2. sheyingshi says:

    It would appear from the article that the Army Medical Command did some pretty serious dancing around the question Mr. Ashton asked without ever giving a definite answer. This of course does nothing to ally the concern that is the article’s topic.

  3. HorseshoeCat says:

    BOO-HOO for Ellis-Billingsley. She gets her just desserts finally from MAMC. It is to bad she is probably drawing a military retirement check and now blasts her employer of at least the last 10-15 years.

    I was a patient of Ellis-Billingsley back in January – February, 1995, having been hospitalized for a suicide attempt while under “investigation” for a supposed act of misconduct.

    I refuse to address her as Doctor in this statement because I know she is something less than an ethical doctor. The first day in Madigan (5-North) she came into my room and grabbed my rank located on my collar and shook it while stating your General is going to bust you in rank. I thought “OMG”, is this the type of care I am going to receive? I was already paranoid enough, not sure who to trust, and just generally scared. I felt terrified by Ellis-Billingsley. Who could I complain to about her conduct? The MEDCOM IG? Who would believe a psychiatric patient in a closed room with a “stellar” doctor assaulting a patient? She put misinformation into my psychiatric records that has never been substantiated by any other doctor or mental health professional.

    In the meantime, the DOD-IG was conducting a review of an IG complaint that I had filed and which was later substantiated that a BG and several of his colonel cronies had engaged in ethical misconduct. They were stupid enough to put certain informtion in writing and as an NCO, I felt obligated to report it. Of course, the BG and his cronies were never punished in any way for their ethical misconduct, which in my opinion was pretty serious.

    Now, so many years later to see she has resigned is great news for the military community.

    She now has the shoe on the other foot and sees that “all the investigations are a charade as the outcome has been predetermined.” If she had one ounce of personal self-worth, she would have stayed and fought the battle. Instead of continuing to milk the system, thank goodness she ran and cried like a little baby.

    Luckily, I finished my military career, but ended up rated as totally and permanently disabled by the VA. Her lack of soldier care, lack of concern for my mental health, and her unbelievable misconduct by physically grabbing my uniform and shaking me remains with me to this day. How she ever reached the rank of LTC is beyond me, although I have my ideas.

    It is sad to see so many years later she is (was) impacting the lives of soldiers. I can only wish my fellow soldiers the very best and to let you know the experiences I had under her care. Yes, I think the “system” is definitely flawed and only takes your personal resolve, persistance, and patience to obtain the desired outcome.

    Good riddance Ellis-Billingsley for all that you did to me and other mental health soldiers.

  4. fanciladi says:

    AND…some people want a National Health Care system…what a joke. My son says…”just look at the VA system and you won’t want that.”!

    He’s been trying to get his benefits since 1998…he’s in the system…they know he’s there…they know they owe him a lot of $$$…they don’t care…they’re waiting for him to die so they don’t have to pay him. Could be a Tillman type of thing but I’m not saying yes or no… They don’t know what they’re doing…the VA and Pentagon…what a combo for our Veterans who have put their lives on the line… They need to get their acts together! Oh…we are paying their salaries on top of all of that…… :(

    Disgusting all the way around….and the Veteran loving P. Murray knows about a lot of this and doesn’t want to be bothered…Dicks knows, too…

    Sorry if you’re bored because you’ve read these and similar comments from me on other posts…but, it’s been going on way too long and I’m an angry Mother of a Disabled Marine!!!

  5. fanciladi says:

    HorseshoeCat…sorry for the run-around you got…that sounds awful…totally awful. My son has had some ‘mental’ evaluations…at least a couple…he said they were totally a waste of time. They say you have to have these to get your benefits…another joke!

    I’m glad this has given you some pleasure…her leaving…yes, Just Desserts…sounds like she really is justly deserving of them!!!

    Thanks for your service!

  6. Is Dr. Juliana Ellis-Billingsley having a bit of a temper tantrum? I hope she does not use the stress associated with a review of her performance of duty as the basis for medical discharge and VA disability compensation.

    Of course army doctors consider potential costs to the DoD when making a diagnosis that would result in either a medical discharge or disability rating from the Veterans Administration.

    The seemingly deliberate refusal to properly diagnose, or minimizing the impact of an illness or condition, was obvious to those who worked in the army personnel system during the mid to late 1970’s Vietnam drawdown. The shameful practice of minimizing or denying disability compensation, for those below the grade of colonel, was firmly in place through 1987, so I am not at all surprised that it flourishes in 2012 when so many of my brothers and sisters suffer from conditions that are not visible to the eye.

    But, the army process is nothing compared to VA establishment. I would not be surprised to discover the existence of a point system that awarded increased pay or benefits to those who managed to eliminate or lower the percentage of disability rating. Is it a written program? No – but remember things like merit pay increases are based on subjective evaluations by their supervisors.

  7. MadiganVictim says:

    A lot of psychology has to do with personal bias and world view of the clinician. Most clinicians do not really leave that at the door. If they see a patient has something in his/record that disputes PTSD they often pounce on that. Nevermind the qualifications of the “Dr” who put it in the Soldier’s records.

    A guy can go on sickcall for sleeping problems and the general practitioner may diagnose a an adjustment disorder. Then later while being seen for related problems it comes up again because “it was already in there” so it must be true. Labels without treatment do not help anyone. Madigan’s favorite flavor is adjustment disorder. Filling in a bubble sheet questionaire can yield different results every time. Don’t be fooled.

    Try going to a doctor/hospital with a history of psychiatric problems. You WILL be treated differently. I guarantee it.

    If someone does not tell every single detail every single time they will say they are “not consistant in their reporting”. Therefore they MUST be lieing. Although a symptom of PTSD is often forgetting part of traumatic events or not wanting to talk about it. They fail to realize that in the real world we do not talk to doctors with a script. We are also not responsible for what they put/do not put in our records. I have seen many variations of the descriptions of my trauma. It is almost comical to read. Until I realize it is real.

    I was one of the Soldiers who went back to D.C. I am not fighting anymore because I am sick of it. They did not “confirm” the MAMC diagnosis, they changed it to something different but still not the same as MAMC.

    You can go to a 100 doctors and get 89 diganosis. Which one is correct? Many symptoms overlap in regards to distress. These people were worried about money. Plain and simple. Perhaps they thought they would be regarded highly if they decided most Soldiers were faking (some for many years). Seems like a lot of effort for a relatively small amount of money compared to a happy life and career.

  8. HorseshoeCat says:

    Madigan Victim: This is the problem with the system. We encourage young men and women to enlist into the service, and as soon as your usefulness is done, they are DONE with you.

    Too many soldiers do not realize how screwed they are going to get and this is soooooooo sad. There are a few very good doctors at MAMC, but then there are some just there for a monthly paycheck and have little or no true concern about a soldier’s mental welfare.

    Go to the VA; it may be time consuming but I bet you will get a fair shake at your earned disability rating. Seems like not a whole lot has changed at MAMC in the past 10 years or so. Thank you for your service.

    Thank you “fanciladi” for your comments. I honestly feel so sorry for the soldier’s fighting the current wars. They do not realize they are just a very small pawn in a very large game played by politicians and others who do not have one iota of care about our soldiers. I wish you son the best of luck. Continue the battle with the VA.

  9. fanciladi says:

    Thanks, HorseshoeCat…appreciate it…he fights as he can…you fight a war, then come home and fight another one on the home front.

    Yup…the politicians and others don’t care… I’ve thought of going to a recruiters office or more with one of those sandwich boards picketing a warning for those about to sign up…but, I wouldn’t do it…

    Thanks again!!!

  10. dankuykendall says:

    I noticed that the comment section of this article is very short on comments. I know hundreds of people that have not had any problems getting benefits from the Army and hundreds that have gotten them from the VA after the army said No. Personaly I have had no problems not telling them everytime I see a medical doctor about my PTSD for continuation of care. Take a minute to look at yourself with some of the blame for not getting everything you wanted or deserve. If you give up, you lose not the system.

    Vietnam combat medic

  11. dankuykendall says:

    And I also think pressure was brought to bear on the changing of these dxs. No way did this many get changed without actually seeing the patients involved. If they were, I would be very suspect of their correctness.

  12. proudofhayden says:

    Juliana Ellis-Billingly has a short memory. While this story has only recently come to light, it has been happening for many years at MAMC. Ellis-Billingsly met with my husband in May of 2010, for 45 minutes at the end of a 1 year TDRL review. By this time, he had been put on TDRL with a 50% rating for PTSD (as diagnosed by numerous MAMC psychiatrists, psychologists and physicians), received a 100% unemployability rating from the VA (also for PTSD) and spent time in a psychiatric hospital for a PTSD program. Yet, Juliana Ellis-Billingsly considered herself to be smarter than every single one of those medical professionals combined. This woman tried to not only overturn my husband’s PTSD diagnosis, but to “rediagnose” him…..with factious disorder! Her report contained insulting, outrageous, factious (yeah, how do you like that verbiage, Juliana????) statements that I tore apart. My appeal went through and MAMC granted my husband a new psychiatric reevaluation. And guess what????? They overruled Ellis-Billingsly.

    Let’s fast forward to today, nearly 2 years after our encounter with this lady who claims to have taken the Hippocratic Oath. My husband has been in three different inpatient programs for PTSD in three different states. He has been in numerous IOP programs and he receives therapy multiple times a week. We are still 100% through the VA, medically retired from the Army and trying to make every day a good one. And Juliana, the Soldier that you stated had “factitious disorder,” was just declared to be SPMI (severely and persistently mentally ill) by the State of Kansas. I guess that this further substantiates my original claim that YOU seem to be the one who cannot keep your facts straight. I still consider your work with my husband to be an ethics violation, if not malpractice. It seems as though many of your other “patients” would agree with me.

    We are not lucky. However, my husband is lucky that he had me to sift through your report and take you to bat. You wrote your report and expected Soldiers to blankly stare at your misguided medical jargon. Well, I stuck it to you. Now, you are stuck with the consequences of your actions. Surely you will never work another soldier again? Shame on you, shame on MAMC and shame on the Surgeon General of the Army, who formed this team and is now leading an investigation while simultaneously trying to cover her own ass.

  13. MadiganVictim says:

    @dankuykendall – Those Soldiers that had their diagnosis changed WERE seen in by the “Walter Reed” team in VA. Not all that were changed were changed to PTSD, however. The thing to note is that different providers often find different things. There are many disorders where symptoms overlap. Also, depending on the provider, some are not as literal in their translation of definitions and symptoms.

    It is a lot different when you go to the VA as opposed to the medical board system. You can be rated for many things from the VA while the Army may only find one thing disqualifying for service and that would be the only thing rated. This is why it is important to note that a LOT of Soldiers were diagnosed with adjustment disorder instead of PTSD. Adjustment disorder is not rateable but they can administratively discharge you without benefits.

    This makes a huge different if someone is to receive concurrent reciept or not. It is also a slap in the face and a question to Soldiers integrity. Not to mention how many other providers are second guessed. Even when someone spends hundreds of hours treating them, the forensic team comes in, waves it’s wand and *POOF* Kick the guy out for having something wrong since birth and not service related. (Even though there was no evidence of psychiatric distress prior). It happens all the time and until things change it will only cause people to be bitter.

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