News 8 Investigates
AMARILLO – As many as 70 veterans in the Amarillo area were diagnosed by unqualified medical workers when they turned to the Department of Veterans Affairs for help for brain injuries they received while in the military, according to internal VA emails obtained by WFAA-TV and our TEGNA Media partners.
Hundreds of veterans in North Texas and throughout the state could have been denied benefits after similar faulty initial diagnostic exams, according to an Amarillo VA doctor who is speaking out about the harm a missed diagnosis causes.
“You want to take care of them, and the VA is not doing that,” said Dr. Roy Marokus, former chief of the Compensation and Pension program at Amarillo’s Thomas E. Creek VA Medical Center. He was reassigned after he began speaking out about problems at the VA.
It’s unclear how many Dallas area veterans are affected. WFAA sent a Freedom of Information Act request seeking answers back in July, and eight months later the Dallas VA has yet to provide any information.
The revelations of Dr. Marokus mark the first time that the VA’s use of unqualified medical staff to do initial diagnoses of traumatic brain injuries, or TBIs, has been documented outside Minnesota.
The problem was uncovered there last fall by our sister station, KARE-TV, which found that VA officials in Minneapolis had not followed the administration’s own rules governing who is allowed to make initial TBI diagnoses.
TBIs from car bombs and other explosions have been called the signature wound of the wars in Iraq and Afghanistan. TBIs are often misdiagnosed as mental health problems, experts say. The symptoms are subtle, but often debilitating.
According to its own rules, the VA mandates that the initial TBI diagnosis can only be done by one of four types of specialists –neurologists, neurosurgeons, psychiatrists and physiatrists.
But records in Minnesota revealed how hundreds of veterans had been examined by doctors who were not qualified.
Some were even denied TBI benefits after an examination by a nurse practitioner.
When veterans got new exams, many finally got the benefits they deserved.
“If it’s in Minneapolis, if it’s in Amarillo, where else is it?” Dr. Marokus said.
Amarillo is in the same national VA network as Dallas. Chris Attig of Attig Steel PLLC is a Dallas-based attorney representing hundreds of veterans in North Texas and around the country.
“You're going to start hearing those problems in North Texas,” Attig told News 8 when he was made aware of Dr. Marokus's revelations. “What you're doing when you’re providing an incorrect or inaccurate diagnosis is you're essentially putting a barrier up between that veteran and his or her return to civilian society. It inhibits their ability to get jobs because they end up treating the wrong condition.”
Internal emails obtained by TEGNA Media reveal that in December, the VA's Veterans Integrated Service Network 17 – known as “VISN 17” – headquarters in Arlington instructed Amarillo officials to review TBI exams which had not been done by the required specialists.
Dr. Marokus said he received copies of the emails even though the exams at issue were done before he arrived in Amarillo in May 2015. Because of patient privacy rules, Marokus did not reveal the names of individual veterans or the details of their cases.
The emails TEGNA obtained state that letters will be sent to at least 70 Amarillo-area veterans “to let them know that they can ask for a re-evaluation” if their initial TBI exam was performed by an unqualified doctor or nurse.
"We are participating in a national review along with every other VA to review / count the TBI diagnosis done by specific specialists," said Dr. Michael Lambert, acting Amarillo VA Chief of Staff in an email to TEGNA Media. "Follow up action will be determined by VA at the national level."
Dr. Marokus, a retired Army Colonel who served two tours in Iraq and says he himself has had a TBI, fears veterans across the country could be affected.
“It’s a hell of a lot of people. A hell of a lot,” he said in a recent interview. “Too many.”
Just days after granting that interview, he was demoted. Instead of heading Amarillo's Compensation and Pension Unit, Dr. Marokus says he was ordered out of his office and is now confined to the hospital library.
KARE-TV executive producer Steve Eckert and reporter A.J. Lagoe contributed to this report.