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GAO: Wounded care better, but more needed

Feb. 28, 2008 - 07:30AM   |   Last Updated: Feb. 28, 2008 - 07:30AM  |  
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Government Accountability Office representatives praised the Army for some of the advances it has made over the past year but said there is still a long way to go in hiring legal representatives to help soldiers going through the disability retirement process.

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Government Accountability Office representatives praised the Army for some of the advances it has made over the past year but said there is still a long way to go in hiring legal representatives to help soldiers going through the disability retirement process.

Also, some treatment facilities lack as much as 40 percent of the staff they need to maintain a ratio of one legal counselor per 30 soldiers, said John Pendleton, GAO acting director of health care, on Wednesday at a hearing of the House Oversight and Government Reform national security subcommittee.

"The Army has made progress in the five months since our September hearing," he said, referring to a previous GAO report showing that the Army's Transition Units were only half-staffed. But one-third of the units still have staffing shortages, he said.

And, 2,500 wounded, sick or injured soldiers waiting to go through the evaluation process remain in their units — and not in the Warrior Transition Units designed to ensure they receive the administrative help they need, as well as allowing trained professionals to keep a close eye on them for medical or mental health needs, Pendleton said.

At some bases, 40 percent of wounded or sick soldiers have not been assigned to a Transition Unit.

However, GAO and lawmakers said the Army has come a long way since a year ago, when Military Times detailed a bureaucratic morass that left wounded soldiers in limbo for months, even years, as they waited on late paperwork.

A subsequent investigation by Military Times showed that disability ratings — which determine how much disability retirement pay troops receive — differed widely among the services, as well as among members with the same medical condition in the same service.

"Let me be the first to say that much has been done over the past year to improve military health care," said Rep. John Tierney, D-Mass., subcommittee chairman "The military services — and the Army in particular — have approached these challenges with great energy and intensity. But let me be equally clear: Much work remains."

Since February 2007, the Army has created Warrior Transition Units with specific primary health care physicians, legal liaisons and a nurse practitioner assigned to each soldier to help him or her through the process.

A toll-free help line has been launched for soldiers with questions; it has received 7,000 calls. An ombudsman program also was created so soldiers would have someone they could feel safe making complaints to.

Army Surgeon General Lt. Gen. Eric Schoomaker agreed there is more to be done.

He said hiring is difficult and the training is tough, but still, "I think we've been very responsible about this."

Schoomaker and his staff concurred with the GAO's findings and offered up reasons and fixes for the problems.

Brig. Gen. Reuben Jones, commander of the Army Physical Disability Agency, said he had requested 57 people to work as evaluation board liaisons; and as of Tuesday, the request was awaiting approval by senior Army officials.

Daniel Bertoni, GAO's director of education, workforce and income security, said the GAO's new report also found that one military evaluation board physician per 200 soldiers is not enough, and that the ratio may need to come down to one per 100.

Schoomaker said previous research showed 200 would be sufficient, but Bertoni said there are surges in disability retirement cases as units return from Iraq or Afghanistan. Those surges can overwhelm the disability retirement system.

Bertoni also said the Army fills the legal representative counselor positions with JAG officers who rotate out within 18 months. The disability retirement system is complex, and Bertoni said lawyers move on just as they become experts — and are replaced by people completely new to the system.

"That's within the Army's control," Bertoni said.

As far as the 2,500 soldiers not in Transition Units, Schoomaker said they had been carefully considered. Some may be injured or ill but are not leaving the military — as in the case of 80 soldiers with amputations who decided to take military jobs they could still perform rather than process out of the service.

Others will not have long recovery or stabilization times, Schoomaker said, so there's no reason to move them from their units. They're also not considered in danger of substance abuse or suicide. In all cases, unit leaders have been involved in the decisions about their soldiers.

However, Pendleton said Army policy dictates that soldiers who remain in their units are meant to be the "exception to the rule."

With 40 percent remaining in their units at some locations, "that doesn't sound like the exception to me," he said.

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