Monday, January 7, 2008

Military Medical Retirements

On the mend
Army disability retirement system better
By Kelly Kennedy - kellykennedy@militarytimes.comPosted : January 14, 2008
When Lt. Col. Chip Pierce served as troop commander at Tripler Army Medical Center in Hawaii, he said he was “frustrated” by some of the issues he saw his injured soldiers face as they made their way through the bureaucracy of the Army’s military disability retirement system.
“At Tripler, we didn’t have the same volume [of soldiers] as Walter Reed [Army Medical Center], so we didn’t have the same level of problems,” he said. “But nearly every problem they had, we had a little of it.”
In some cases, he didn’t know where to turn to solve a problem, he said. And he “wasn’t satisfied” with the troops’ living quarters.
So when the Army offered Pierce the opportunity to lead its new Warrior Transition Unit, a brigade designed specifically to address the administrative needs of injured soldiers, “I couldn’t get here fast enough,” Pierce said.
That was last spring. Already, he said, he’s seen progress.
In February, Army Times reported that soldiers languished for months — even years — in the medical hold system, facing bureaucratic tangles as they worked their way toward the physical evaluation board to determine their disability rating for retirement pay.
The stories, as well as reports from the Pentagon Inspector’s General and Government Accountability Office and testimony of injured soldiers before Congress, brought about a series of investigations and planned changes. And the new Warrior Transition Unit meant officials could immediately put some of those changes into effect.
“Before, folks didn’t feel they had the power to make change,” Pierce said, referring to a stifling set of 50-year-old policies and procedures. “Now, everyone is an advocate for change. If something isn’t working, they can fix it.”
Since then, the Army has added staff, improved training for counselors and lawyers, and ensured every soldier has someone overseeing his or her progress through the system.
And Building 18 — Walter Reed’s dilapidated symbol of the breakdown in the system — no longer houses wounded soldiers.
“I’ve been fortunate to be able to see the frustrations and bring them up to this level,” Pierce said. “It’s been very satisfying to be in this position.”
Increase in medically retired
While the number of soldiers medically retired — meaning they received a disability rating of 30 percent or higher or had at least 18 years of service when they went through the disability process — declined from 2005 to 2006, it increased by several hundred in 2007, according to figures provide by Col. Carlton Buchanan, deputy commander of the Army’s Physical Disability Agency.
Moreover, Buchanan said, while 270 fewer soldiers were medically retired in 2006 than in 2005, the percentage of those completing the evaluation process who were medically retired went up over that time, and has continued to rise in 2007:
• In 2005, 13,048 soldiers went through the process and 2,232 were medically retired, about 17.1 percent.
• In 2006, 10,460 soldiers went through the process and 1,956 were medically retired, about 18.7 percent.
• And in 2007, 10,400 soldiers went through the process and 2,397 were medically retired — about 23 percent.
The 8,003 soldiers who weren’t medically retired in 2007 either were found fit and remained in the Army, were awarded a lump-sum severance payment based on rank and years of service, or were separated without benefits if their condition was found to be pre-existing and they hadn’t been in the military for at least seven years.
Pierce said about 8,900 soldiers remain in the Warrior Transition Unit waiting for their final disability evaluation board.
Tracking individuals
Things still aren’t perfect; Pierce said it’s hard to judge how soldiers feel about the improvements because they weren’t in the system a year ago. And there are still cases taking longer than they should to go through the process.
But now, rather than justifying a months-long quagmire, as had been done by other officials in the past, Pierce said his office tracks, by name, every soldier whose transition takes longer than 60 days. Prior to the 60-day mark, soldiers’ squad leaders in the Warrior Transition Units are responsible for making sure soldiers move through as quickly as possible.
The GAO reported in the fall that some transition units are only at half staffing, but Pierce said the necessary ratio of staff to injured soldiers is at the right levels. In some cases, he said, the GAO report called for staffing for 100 injured soldiers when there may have only been 25 soldiers in the unit.
The Marine Corps also stood up a Wounded Warriors regiment last spring to keep track of Marines and sailors going through the disability retirement system. Though the Navy and the Marine Corps have a better track record for getting service members through the process, there have been worries about the equity of their ratings system.
An Army Times investigation last spring found that enlisted Marines lag far behind enlisted sailors and airmen in the size of the average disability payments they are awarded.
Soldiers, Marines still lag
The 2006 data released by the Defense Department’s Office of the Actuary show Marines and soldiers continue to lag, even though they have higher injury rates and could be expected to have a greater proportion of serious injuries because of the wars in Iraq and Afghanistan than do sailors or airmen. Their ranks and times in service were also comparable.
The average monthly disability payments for all enlisted members receiving disability pay from the military in 2006:
• Air Force: $963
• Navy: $845
• Army: $792
• Marine Corps: $774
Officers had similar discrepancies:
• Air Force: $2,668
• Navy: $2,392
• Marine Corps: $2,336
• Army: $2,067
According to the Office of the Actuary, the number of Marines medically retired in 2006 went up by about 200 compared with the previous year — far more than any other service. The Marine Corps did not comment on the figures by press time.
The Air Force and Navy also saw increases in permanent disability retirements from 2005 to 2006 of 125 airmen and 36 sailors.
Buchanan said part of the reason for the Army’s increase of more than 400 disability retirements in 2007 was that combat-related injuries rose to 18 percent from about 15 percent the year before.
Among soldiers going through the military disability evaluation process, more than half of those with combat-related injuries are retired, Buchanan said.
Another reason for the increase, he said, is “increased training of physicians and adjudicators, coupled with greater precision in describing injuries, such as scars, muscle and nerve injuries, as well as mental disorders.”
That gives medical boards better information to determine proper disability percentages, he said.

Sphere: Related Content

No comments: