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If it is lower, the soldier receives a one-time severance payment, calculated by multiplying his number of years in service by his monthly pay, and then doubling the total.

Lt. Col. Mike Parker started having back problems eight years ago.

He couldn’t carry heavy packs. He had to be near medical facilities. And he needed to keep his medication refrigerated.

He was sent before a medical evaluation board last fall to determine whether, after 18 years in uniform, he could still do his job and stay until retirement.

The board found he was fit for duty as an acquisitions officer. “and that was the end of the story,” Parker said.

Almost.

While doing research about his disease, Parker found another service member, Air Force Staff Sgt. Robert Booth, who took the same medication for a similar autoimmune disease that causes back problems: Parker has reactive arthritis; Booth has ankylosing spondylitis.

But Booth’s medical board found that because, like Parker, he needed to remain near medical facilities and refrigerated medication, he was unfit for duty.

Booth, an 18-year veteran, was medically discharged last fall with a 10-percent disability rating: no retirement, no medical benefits.

Parker said that made him realize he could have been the one “given the boot without retirement.”

“I couldn’t believe how low [others] were being rated,” he said, emphasizing he spoke only for himself, not his command. Parker continued researching his disease and contacted other service members going through the medical evaluation process. He discovered the system was being swamped by thousands of claims filed by a new generation of soldiers.

From 2001 through 2004, the number of active-duty and reserve claims made with the Army Medical Evaluation and Physical Evaluation boards nearly doubled from 7,218 in 2001 to 13,748 in 2005

A soldier goes before a physical evaluation board if a medical evaluation board determines he is not able to do his job. The physical evaluation board then determines how much the Defense Department will compensate the soldier.

A report by the Government Accountability Office released in March found that no one is checking the consistency of the boards’ decisions — whether some soldiers’ claims are rejected as others with similar disabilities earn benefits, for example.

in April, the House slipped a section into the 2007 defense authorization bill aimed at helping soldiers make their cases during physical evaluation boards, a change Parker has been pushing for.

The House bill, seeking to expedite claims and bring some consistency to rulings rendered in cases involving similar medical conditions, mandates that physical evaluation board members document each item in their decisions, and that the secretary of defense establish training procedures for counselors who help soldiers through the board process. The bill also mandates changes to make sure decisions are handled in a timely manner and requires the secretary of defense to ensure the new policies are enforced.

An advocate for consistency

After his medical board ruled he could resume his military duties, Parker began spending his spare time digging into the cases of a dozen troops with the same disease.

he noticed the same patterns emerging — patterns that left the soldiers, sailors and airmen he talked with confused and sometimes bitter about the way their cases had been handled. He provided Army Times with documentation for a half-dozen of those cases.

Parker started making phone calls — a lot of phone calls — on the service members’ behalf, and set up an in-person meeting with a House Armed Services Committee staffer in early December.

Randy Reese, national service director for Disabled American Veterans, said his organization is monitoring the defense bill and that he has worked with Parker. DAV provides civilian counselors for soldiers who request them during the physical evaluation board process.

“There’s been a lot of change because of Lieutenant Colonel Parker,” Reese said. “Service members often get low-balled because there are no checks and balances. I think there is room for improvement. It doesn’t take a big regulation, just a little language and the impact can be dramatic.”

Parker was diagnosed with reactive arthritis, a disease similar to “ankylosing spondylitis” in which the immune system response goes haywire and attacks beneficial protein along with invading bacteria. That causes the joints in the spine to inflame, triggering severe, chronic pain where the spine joins the pelvis.

Parker takes Enbrel, a drug that suppresses his immune system — which causes problems of its own. If bad bacteria attacks while he’s taking Enbrel, his body can’t fight back, which is why he needs to be near a medical facility.

“If I get shot,” Parker said, “it’s not good.”

Parker said he believes the medical evaluation board members decided to keep him in uniform because, unlike the airman, he had reached retirement eligibility and would be paid whether he stayed active or left the service. Booth’s low disability rating meant the Defense Department did not have to pay him retirement or disability pay.

Equal treatment

Parker’s not arguing that Booth, who also takes Enbrel, should have kept his job. Rather, he just wants service members to be treated the same.

The proposed legislation in the defense authorization bill would do just that.

As he continued his research, Parker began posting information about the physical evaluation board process on a Web site for the Spondylitis Association of America at http://www.spondylitis.org/ and about a dozen men contacted him asking for help.

But rather than just tell the airmen, soldiers and sailors what to do, he volunteered to go through their paperwork, typed up point-papers to help them support their cases and met with their lawyers and counselors to explain the disease and the regulations that applied to it.

If necessary, he went to the evaluation boards with them. If they had already gone through the process, he wrote letters to doctors, Veterans Affairs Department officials and politicians to help the service members appeal their decisions.

Why do this? “No one else is,” Parker explained. “With the war, the lawyers are backlogged and not well-informed about how the law works with all these different diseases.”

In its March report, the GAO pinpointed several problems in the medical evaluation process:

• The Defense Department and the services do not have a consistent system in place to monitor the way cases are handled.

• The services do not have a formal training system set up for the people who help troops through the physical evaluation board process.

• The Army does not keep good statistics on how long it takes to process soldiers’ physical evaluation boards, so it can’t be determined whether they are handled in a timely fashion.

The Defense Department agreed with the recommendations, and William J. Carr, acting deputy undersecretary for military personnel policy, responded in a March 9 letter that the department would implement all of the GAO’s recommendations.

Parker said the report hits on a lot of problems, but not all of them.

He points out that to receive retirement pay, a service member has to be rated at 30 percent disability or higher. That qualification is important for the monthly stipend, and more important, the lifelong medical benefits. Enbrel can cost $20,000 a year.

Full disclosure

In February, Army Capt. James Wollman received a severance package of $23,000 — no retirement benefits — because his physical evaluation board determined that his ankylosing spondylitis was a pre-existing condition.

He — and Parker — say it was not. Wollman’s symptoms surfaced during physical training as an ROTC cadet in 1992.

At the time the pain was ruled not to be spondylitis, a ruling that was repeated in a 2001 exam when Wollman experienced similar pain.

He suffered similar symptoms again in 2003 while on a combat tour in Iraq, which led to a move from his position as a field artillery officer to a desk job. This time, he was diagnosed with spondylitis.

Meanwhile, he learned that his deployment medical records had been lost.

when Wollman started the medical evaluation board process, he told the doctors that he had received a waiver to get into the military. In fact, he realized later, there was no waiver. His college doctor said a waiver was unnecessary and that he was fit for duty.

The board used the waiver to show Wollman’s pain came from a pre-existing condition, which means he can’t be medically retired from the military and therefore can’t receive medical benefits. Instead, he was found unfit for duty and processed out. He’s awaiting his Veterans Affairs board to find out if he qualifies for benefits. When Parker found out, he walked Wollman through the regulations to try to help him with his case.

The proposed legislation could make sure soldiers like Wollman receive full documentation so that it’s easier for them to say, “Hey, that’s not right.”

‘A system gone astray’

In Wollman’s case, the waiver error might have come out earlier if the board had been required to document it.

Lt. Col. Marie Domninguez, a surgeon with the 1st Armored Division, wrote a letter to the physical evaluation board on Wollman’s behalf.

“I believe his findings have been based on an incomplete medical history and factual errors included on the narrative summary that were prejudicial to a fair and unbiased hearing,” she wrote. “To me, it is an injustice to thoroughly evaluate someone for a condition, determine that it does not exist, bring them on active duty for seven-and-a-half years, and then determine that the illness existed all along, and that, therefore, he will not receive any VA coverage for the illness, nor qualify for insurance coverage under most policies.”

But the letter brought about no change.

Disabled American Veterans spokesman Reese said the story isn’t unusual.

“It can be a really trying time for people who are hurt to start with,” he said. “We’ve been doing this since Vietnam, so it’s nothing new for us. The inequities really come to light when you’ve got so many people going through the system.”

As he waits to see if the changes to the defense authorization bill will make it through the process, Parker continues to post messages seeking out service members who need his help.

“Most of them wanted to stay in and serve their country,” Parker said. “But the culture is ‘They’re sick, lame and lazy: You’re not getting a retirement out of us.’ This is only a tiny example of a system gone astray, and I think someone needs to call the Army on this.”

Here’s how the process works:

• A physician evaluates the soldier’s injury or disease.

• The doctor’s report initiates the medical evaluation board process. At least two doctors informally decide whether that soldier can return to duty. If so, he goes back to work — process over. That’s all supposed to happen within 30 days of the first diagnosis, according to Army regulations.

• If not, the medical evaluation board doctors forward their evaluation of the solder deemed not fit to return to duty to the Physical Evaluation Board. The soldier selects a counselor, either from the Army or a civilian provided by the Disabled American Veterans. Without the soldier present, the Physical Evaluation Board conducts an informal assessment. Three voting members — a combat arms colonel, a personnel management officer and a physician — look at the evidence and decide whether the soldier is fit for duty. If so, the soldier is returned. If not, the board assigns that soldier a disability rating, based on injury- or disease-specific factors.

• If the disability rating is at least 30 percent, the soldier gets medical benefits for life as well as the same percentage of base pay.

If it is lower, the soldier receives a one-time severance payment, calculated by multiplying his number of years in service by his monthly pay, and then doubling the total.

• The soldier then talks with his counselor about whether he should accept the recommendations or request a formal hearing.The government does not argue its case against the soldier — the board is there to hear the evidence from the soldier.