Monday, October 19, 2009

Malingering

Malingering used to be called 'gold-bricking', or 'lying' and it used to get you fired.

I am here calling on all of you who may work in the military medical system or the VA system. Can you tell me what happens to malingerers in the military now or in the VA system. I think I know the answer, but I want you to tell me. Malingering, you do it and you get what?

Along these lines for you in the military, what does going A.W.O.L. get you now? Educate me.

Can't wait for the same kind of thinking and rules to be applied across the board to all Americans under Obamacare.

16 comments:

  1. Where does malingering get you? As all American physicians know, it often gets you a lifelong income stolen from some working productive citizen, labeled as "disability payments" or some such crap. As H.L. Mencken said, "Americans used to work for a living. Now they vote for a living."

    Doesn't it make ya BOIL??!!??

    MADDOC

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  2. I'm still active duty, but I can only answer from a Navy perspective...the ranges are:

    Malingering:

    1. Informal counseling

    2. Formal Counseling

    3. Extra Military Instruction (EMI)

    4. Captain's Mast

    5. Administrative Separation

    AWOL (or as we call it; Unautorized Absence)

    1. Captain's Mast

    2. Restriction; loss of rank; loss of pay

    3. Correctional Custody (Brig time)

    4. Separation under other than honerable conditions.

    5. If greater than 30 days, the Sailor is classified as a deserter and a federal arrest warrant is issued. All pay and privileges stop. If picked up on the warrant(we don't actively pursue deserters anymore. Eventually they screw up and get picked up by local authorities, usually on a traffic stop) the Sailor is usually cour-martialed and may receive a Dishonerable Dischare or Bad Conduct Discharge (Both are considered felony convictions)

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  3. Malingering??? You mean Article 115 of the Uniform Code of Military Justice? Its a Court Martial Offense, punishable by up to a Dishonorable Discharge, Forfeiture of all Pay and Allowances, and up to 1 yr Confinement...

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  4. thank you gents, and next question, can one receive disability benefits through the VA for the diagnosis of 'malingering'? if so, at what percentage?

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  5. The VA is pretty good at sorting out who gets and does not get benefits. It gets a little squishy when it comes to post traumatic stress disorder. My boss, who knows nothing about the military, frequently needs to be jolted with facts to get him back to reality. He always falls for the sad story about being injured in Iraq, and now having severe back pain. There are ZERO people getting injured in Iraq and being denied VA benefits.

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  6. anon.
    i am not sure i agree with you. but i want my evidence to come from someone inside the system.

    can one get a disability rating for 'malingering' in the VA system?

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  7. 911,
    "Malingering" is a legal term as Frank pointed out and is a specific violation of the UCMJ. Separation for such an offense under other than honorable conditions precludes receiving any VA benefits. However, a psychiatric diagnosis of, and a medical discharge for a personality or adjustment disorder that can be classified under the DSM is a whole 'nother ballgame.

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  8. I've worked for the Spa for nearly 20 years. I've never seen a SC rating specifically for "malingering". If someone truly is malingering and is ID'd as such I don't see how they could get a SC rating.
    If they are never dx'd w/ malingering, then yes, I have seen pts get SC rating for sx that are not substantiated by testing/exams.
    CardioNP

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  9. As is my wont, I have a useless observation.

    My first play, ever, in high school football was a punt return for a touchdown. My second, ever, play was a punt return for a trip to Womack Army Medical Hospital, on Ft. Bragg. Apparently, my first play had somewhat irritated the opposition and I got hit by two guys, at approximately the same time, from opposite directions.

    Anyway, the medic on duty at Womack (my parents had to drive me there, there being no high school on post), said, "Damn". However, there was no doctor on duty. He was apparently malingering. When the lady doc finally got there, she was most unkind and yanked my body parts with passion, while cussing about the malingering doctor. As a result, I played no more football, casts being discouraged on the field, and I supported the election of Carter. These are serious consequences.

    So, that is my professional opinion; the punishment for malingering hurts like crap, for the malingered patient, and can lead to four years of malaise.

    I hope that helps.

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  10. HIPAA prevents me from giving you the answer about malingering and disability ratings and the VA.

    My friends who are currently active duty USA tell me that AWOL folks are now routinely given OTH D/Cs and sent on their merry way. It's cheaper, evidently, than prosecuting.

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  11. I work for the VA system. It depends how one defines "malingering" because it usually ends up with a lovely handle like "somatization disorder" and the vet gets a psych disability. I would cheerfully state--pauses to put on flak and Nomex--that over 50% of the vets I treat aren't actually disabled due to anything other than sorriness. Most psych disabilities are a crock.....PTSD? Ok, it exists. But most of these guys were antisocial violent idiots before they went to VN, where they sat in the rear and hauled cases of soda---they just now have an excuse.

    The men I know who really have PTSD are functioning in their daily lives.

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  12. Anon - Funny you should say that. I had a neighbor who I knew had served in combat in Vietnam, had lost friends there, and was injured in the line of duty. I had no idea how much he had endured until I talked to him after one Fourth of July.

    I noticed that he wasn't home while the rest of the neighborhood had shot off fireworks. I presumed he had gone elsewhere for the holiday, and I asked him how his 4th was. He said it was good because the sedatives had put him to sleep, so he didn't hear the fireworks. He said he was ok as long as he could see them being lighted off, but being indoors and hearing them sounded too much like gunfire and mortars.

    This guy was a great neighbor. I was bummed when he moved. Like you said, he was productive and friendly and functioning in his daily life. But it was very depressing to learn that a person who fought for this country is unable to really enjoy the celebration of its independence!

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  13. The Last Psychiatrist wrote something similar.
    http://thelastpsychiatrist.com/2009/10/how_am_i_going_to_get_paid_if.html

    "If you have a 25 year old unemployed actor for a son who lives rent-free in your house and spends your money on chest waxing and self-tanning cream, and he can get a doctor to believe this depresses him, he can get Medicaid"

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  14. "But most of these guys were antisocial violent idiots before..." I LOVE the fact that you state that you work for the VA. You are a moron and should have ABSOLUTELY NOTHING to do with the well being of our soldiers. But then again, we all know about the VA's reputation for treatment of our vets dont we?

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  15. There are alot of POGS who sit in the rear on deployments and dont do shit. When these guys claim PTSD to me its amusing, when they are asked what its from they always say "mortars hit the base all the time I thought I was gonna die!!!" But really the chances of getting hit by a mortar, in most cases of mortar attacks. Is about the same as randomly getting hit by a -car. I was in the infantry in Iraq from 07-09 for 15 months it wasnt the worst time to be there but we took contact of some sort about twice a month and I fired my weapon only three times. But I can tell you since I came back almost every night I have extremely violent dreams, I jump at noises that sound like gunshots and run for a weapon from time to time, yeah I think PTSD is real.

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  16. In case no one answered, no a formal diagnosis of malingering is not a SC condition. It basically means there was no or not enough useful information obtained in evaluation as person provided false or exagerated information. One can reapply or sometimes a new exam is ordered.

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