Soldiers trapped in limbo

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http://www.boston.com/news/globe/editorial_opinion/oped/articles/2007/03/21/soldiers_trapped_in_limbo/

Soldiers trapped in limbo

By Linda Bilmes, Globe Columnist | March 21, 2007

ON THE fourth anniversary of the invasion of Iraq, one of the lasting images for Americans remains the squalid conditions at Walter Reed Army Medical Center. Who can forget the pictures of soldiers recently returned from the battle, trying to recover from horrific wounds while forced to keep fighting against dirt, mold, and bureaucracy?

The seeds of the Walter Reed scandal were sown in weak leadership, heavy reliance on outside contractors, and a failure to foresee the sheer number and severity of casualties. But the real culprit lies in a lack of trust between the Pentagon and the Department of Veterans Affairs. When a soldier is injured, the military decides whether he or she is fit to return to duty. If not, a second level of evaluation determines just how unfit he is. Soldiers awaiting this second level evaluation -- including those at the Walter Reed outpatient clinic and scores of other military bases -- are often trapped in limbo between military and veteran status.

Of the 1.4 million of service members deployed to the Iraq and Afghanistan wars, about 53,000 were officially listed as wounded or injured. Tens of thousands of others suffer from less visible wounds, such as traumatic brain injury, post-traumatic stress disorder and debilitating chronic pain.

The military does not have enough healthcare practitioners to evaluate all soldiers before discharge. Some simply stay in the military, knowing that if they leave, they lose valuable housing and healthcare benefits, especially for their families. Others go to a VA hospital for an evaluation, either because they gave up waiting or they aren't satisfied with the military evaluation and hope the VA will do better. As a consequence, the transition from active duty to veteran status becomes a quagmire instead of the seamless process desired by both departments.

This bureaucratic turf war extends beyond the wounded. More than 200,000 war veterans have already been treated at VA hospitals and clinics. But a penchant for privacy and outdated information technology means the Defense Department is unwilling and in some cases unable to provide medical records to the VA and thus to provide a continuity of care. Even when the VA gets the records, it often insists on repeating all the medical procedures and diagnostic tests before disability status can be granted. Many veterans travel 90 miles or more to reach the nearest VA medical facility. Even veterans already in a wheelchair must endure this prolonged, costly, and redundant process.

Soldiers injured in theatre are supposedly able to apply for disability benefits before they are discharged. But to take advantage of the program a soldier must know when he is going to be discharged. Unfortunately, much of the force doesn't know when it will be discharged because of repeated deployments and "stop-loss" orders. Furthermore, National Guard and Reserve soldiers are excluded from the pre-discharge program.

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