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Army thins warrior transition entrance rules

When Army generals recently appeared before Congress to testify about staffing problems at the service’s Warrior Transition Units, they laid out several new changes to fix those problems.

But they left out a key part of the plan: It lowers staffing needs at the WTUs by freezing out thousands of wounded soldiers.

“The Army issued a Fragmentary Order on July 1, 2008, refining the entry criteria for WTUs,” Lt. Gen. Eric Schoomaker, Army surgeon general, wrote on a medical command Web site. “Two base requirements: six months’ expected rehabilitative care and the need for complex medical management.”

But the scandal that erupted last year over mismanagement at Walter Reed Army Medical Center in Washington, D.C., showed that leaving soldiers in their own units as they go through the medical retirement process can cause problems in two ways:

• The process is delayed by line-unit personnel who don’t know how to handle medical retirement paperwork.

• First sergeants are stuck with nondeployable soldiers in deployable slots, creating an adversarial relationship between soldiers and their commands.

A recent case at Fort Lewis, Wash., shows how this can happen. A month ago, a soldier told Army Times his company has several soldiers being medically retired. He said his first sergeant told them they had better keep their noses clean or he would process them out on Article 15s because he needs deployable soldiers in their slots.

Meanwhile, the soldier said he has been assigned staff duty during times when he had out-processing briefings or medical appointments, and was told if he misses the duty, he’ll be in trouble. Then he was told he already had orders to go to the WTU — good news because he’d had to fight to get paperwork written up and signed.

Then last week, the soldier found out his transfer to the WTU had been frozen under the new order that went out July 1.

The soldier said he doesn’t mind pulling duty; he deployed to Iraq with the knee injury that is forcing him out of the Army. But he does mind being treated as a problem. And, he said, he feels as if he needs to watch his every step for fear that a bad move could lead to a dishonorable discharge.

Bad all around

“It’s a bad situation for the soldier, it’s a bad situation for the first sergeant and the commander,’ ” said retired Army Lt. Col. Mike Parker, who has worked as an advocate for service members going through the medical retirement process. “It’s not fair and it’s dangerous to have an understrength unit training up to deploy for combat.”

At the July 22 hearing of the House Armed Services personnel panel, four Army generals talked about being “overwhelmed” by the number of soldiers entering the WTUs, which grew from 6,000 in June 2007 to 12,000 in June 2008, and is expected to grow to 20,000 this winter.

Lawmakers berated the military officials for understaffing at the WTUs. Fort Hood, Texas, for example, had 1,342 injured or ill soldiers in June, but only enough staff to support 650.

But Brig. Gen. Gary Cheek, assistant surgeon general for warrior care and transition, said that between 10 percent and 30 percent of the soldiers “don’t need the managed care that we have in a Warrior Transition Unit.”

He said the new order “unencumbers the local commander; it empowers him or her, and it also gives very clear standards to each of us on how we’re going to take care of our most vulnerable — our wounded warriors. We’re committed to doing that.”

But Rep. John McHugh, R-N.Y., who questioned the generals at the hearing, seemed surprised about the details of the order.

“I certainly have a concern with the narrow entrance criteria now required for WTUs and how that is going to impact the recovery of soldiers even with the so-called ‘less-complex’ cases,” he wrote in a July 31 e-mail response to questions from Military Times.

“It is going to be incumbent on the Army to ensure the soldiers remaining in their parent units during recovery are provided the support necessary to attend medical appointments and have their physical ailments accommodated without the associated pressure inherent in line-unit environments,” McHugh wrote.

Subtracting patients

One advocate, who asked not to be named because he fears losing his job, said insiders at Fort Hood say the WTU waiting list is closer to 1,000 soldiers, and that people already in the WTUs are being removed and sent back to their line units before they finish their medical retirement process.

“They don’t have nearly enough staff to do what they need to do,” the advocate said.

Parker said one possible way to alleviate the staffing and billeting issues: Have the soldiers perform staff duty or other duties, but let the WTUs provide a schedule of what hours the soldier is available to work; and double-billet them — if nondeployable soldiers are assigned to line units, simply don’t slot them in deployable positions.

Dr. S. Ward Casscells, assistant secretary of defense for health affairs, talked about the new Army order July 25 on the Military Health System Blog.

“It’s important to recognize that only 13 percent of the soldiers within the Army’s WTUs actually suffer combat injuries,” Casscells wrote. “Some of our WTUs have been overcrowded as cautious commanders have assigned soldiers with even the smallest of medical problems to those units.”

On Schoomaker’s blog, a soldier complained that the WTUs are seen as “the place to be when you are hurt,” and that he talked to commanders “who seem to feel that any soldier on profile should be in the WTU — this is especially common with units trying to deploy soldiers.”

“Your concerns are rightly place[d] and we are shifting the focus on WTUs back to soldiers with complex medical issues,” Schoomaker said. “Don’t expect a change overnight, but over time we will see a WTU more in line with your comments.”