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Other experts agreed. "In an emergency setting, a patient with insomnia who does not report stressors or substance use, who denies suicidal or homicidal thoughts and who otherwise does not have urgent psychiatric or medical issues would typically be referred for further, full evaluation of the insomnia in a nonemergency setting," said Dr. William E. Narrow, acting director of quality improvement for the American Psychiatric Association.
The AP obtained 114 pages of Alexis’ medical records under the Freedom of Information Act after requesting them a few weeks after the shootings. It is unusual for the government to disclose anyone’s medical files, but the Veterans Affairs Department agreed that the public interest in the mass killing outweighed Alexis’ privacy rights in keeping his treatment records secret after his death. In the records the AP obtained, the government withheld the names of all the doctors and others who treated Alexis to protect their privacy.
Congress and the Pentagon are investigating the shootings, including whether faulty security clearance procedures allowed him to get and maintain his job. Some lawmakers have said Alexis fell through the cracks at the VA and should have been treated by mental health professionals, but they have stopped short of specifying what government doctors should have done differently.
The medical records also describe Alexis’ efforts to qualify for disability payments because of ringing in his ears and orthopedic problems. In February 2011, almost immediately after Alexis received an honorable discharge from the Navy, he complained about tinnitus, which he said was "annoying and can be distracting." He said it began in 2009 when he was still serving in the Navy. An audiologist in Dallas determined that his hearing in both ears was "within normal limits" and said any hearing loss or tinnitus probably didn’t occur when he was serving in the military.
In October 2011, Alexis filed another disability claim for what he said was a broken right foot he suffered when he fell down stairs in 2009, causing him mild to moderate pain daily. The Navy alleged in a nonjudicial punishment in July 2009 that Alexis was drunk when he leaped off stairs and suffered a broken ankle, but Alexis appealed the disciplinary action and it was removed from his record six months later because there was insufficient evidence he had been intoxicated. Alexis also complained to the VA about a spine problem and conditions with his knee and shoulder. An examiner concluded that Alexis had a degenerative disc in his back and less movement than normal in his shoulder and knee.
The government granted him a 20 percent disability rating for orthopedic issues in December 2011. He was awarded an additional 10 percent for tinnitus and received $395 in monthly benefits retroactive to his leaving the Navy, or about $4,740.
Associated Press writer Eric Tucker contributed to this report.
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