Warrior Care Webhall

The Military Health System will host a Web town hall on Nov. 19 from 2 to 4 p.m. Eastern time on www.health.mil as part of the ongoing dialog between senior military leaders and service members and their families about the Defense Department’s medical care programs and services for its wounded, ill and injured troops.
 
Providing care to wounded, ill, and injured service members is a top priority of the Defense Department and MHS. Senior Defense leaders are committed to ensuring service members, families and care providers are continually informed about the latest transformation of warrior care news and improvement of services.
 
“We want to share with service members and their families about the progress we’ve made to find solutions that work,” said. Dr. S. Ward Casscells, assistant secretary of defense for Health Affairs.  “We want to hear from you directly, so please join us online on November 19.”
 
The online event will feature a live Web discussion with senior leadership and subject matter experts on warrior and family and veterans issues. It will provide participants with the opportunity to interact with an array of service members and families who have been touched by warrior care. 
 
Town hall participants may submit questions starting today (Nov. 14) and throughout the live program on Nov. 19. Send your questions to mhswebcontent@tma.osd.mil. Click here to obtain instructions on how to participate in the event. For privacy reasons, we ask that participants limit discussions to broad issues and lessons learned, and to not disclose personal information. When possible, service members should contact their chain of command to resolve issues.
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SSG Sharon Collins at 2008-11-14 19:04:14 wrote:

Why is it so hard to get a truthful answer about what is going on for the Reserve and Guard in regards to the MEB? You get a different answer from every person instead of them admitting they don't know the answer because they don't understand or know they rules concerning the Reserve and Guard. It seems all we get is lip service.
Sharon Collins at 2008-11-14 19:08:23 wrote:

If healing is our priority why is it some think if we aren't able to work because of our medical condition we should sit in a room all day where we may be kicked out for a meeting and have no other place to go because we are banned from the orderly room without a Cadre? Why can't we heal where we are staying so we can be comfortable and stress free? I was told to my face since I was drawing a paycheck from the Army I should be at work and if I couldn't work or take a class I should have to sit all day at the unit.
william schuyler at 2008-11-15 10:50:11 wrote:

With a new administration, what plans are being considered if a cut in the military occurs? What impact on TRICARE will this have? I know it is early but everyone can see the hand writing on the wall.
Tracy Hejmanowski, Ph.D. at 2008-11-18 08:27:22 wrote:

I would like to submit three comments from a clinical perspective (I will be
unavailable during the town hall):

1. Recommend that clinical / mental health resource summits are held within
regions that aim to simply connect regional providers of care with each
other so as to minimize both gaps and redundancies in the coordination of
care. Awareness is key to utilization and provision of services. The wheel
need not be reinvented unnecessarily at the expense of cutting edge and
timely care.
2. Clinicians need to be aware that the PDHRA process may yield minimization
of symptomatology and medical/mental health concerns and follow-up the
post-deployment health assessments with a focused clinical interview, even
if brief.
3. Providers outside of the military treatment facilities should be provided
with ongoing "cultural competency" training if they are to work with active
duty (MilOneSource), Reserve/NG or veterans (Tricare, private providers,
etc.). The military is not unlike other special populations requiring
specialized clinical training. Post-deployed service members need providers
who are savvy about military life and deployment-related stress in order for
treatment to be successful.

Thank you for your consideration of these items. I look forward to hearing
about lessons learned from this initiative.

V/r,
Dr. Hejmanowski
Meghan E. Malloy at 2008-11-18 08:28:49 wrote:

I was excited to see the concept of the Warrior Transition Unit come to fruition. I can't agree more that combat wounded troops deserve the best that we can give them. However, we've gone too far. Soldiers straight out of Basic Training and AIT, that have never seen combat, are being given same day priority medical care. Yet Soldiers that have deployed multiple times and have sustained injuries and illnesses that may not take them to the WTU, are made to wait days, weeks, and sometimes months to see a physician, much less in a specialty clinic. Typically our only option is sick call, where we wait in line for hours to speak with a PA that spends less than 10 minutes with their patient and often neglects or refuses to request needed tests such as labs or MRIs. Yet for the AIT Soldier that has never deployed that belongs to the WTU, the best care is given and no expense is spared.

In addition, Soldiers that are currently coming back are screened and re-screened for every type of ailment. The first time we returned, in 2003 from Iraq, there was no such thing as a PDHA or a PDHRA. How many Soldiers that deployed then were missed and will never recieve treatment? I returned again from Iraq in 2006 after being deployed as a medic, attached to an infantry unit and an EOD unit. When I got back and couldn't sleep, I was told at my PDHRA that I was addicted to caffeine, so I should stop drinking soda. At that point, I lost all faith in the Army medical system.

V/R,

Meghan E. Malloy
SSG, USA
William H Hoesen Sr at 2008-11-18 08:30:51 wrote:

When is our Tricare for life Health care system, going to be made to work for us.

We the patients do not get to contact the doctors that are assigned to Us, there are numerous Departments that we have to try to go through, we say try, because that is all we can do.

We are send from one department to another because the one department can not or is not able to satisfy our question for help, Information or advice.
The other department we are send to, is nine times out of ten, not able to get us any further than, to send us to the next department, and so on and on, until we finally are send back to the first department we started out with, in each case of course we have to leave a message and wait and wait for a reply that more than some times never comes.

We like to Inform you that this, is known to us as the Governments system, outside the Military, that stands between us and our top Commander, that likes to create jobs for people in these, boxed in restricted departments, that are set up to accomplish nothing, nor produce anything, their Job description is made up that way, this is called the ultimate example of Job protection.

Now that we made this clear, when Is the Military System going to wake up to this fact, which has been to the Military like our Enemy, for now more than a half a Century.???????

Lets accomplish, do something to correct this, once and for all, now that we know, that this outside the Military System has proven itself to be Undependable, untrustworthy, and undeserving, rid yourself of it and do the job ourselves, with a system, over which we have Quality control, and that works, we know how to do that, and have proved it in the Past!

William H Hoesen Sr 83+, Ret:WWII Mil:
Jace BADIA at 2008-11-19 13:33:02 wrote:

I was injured 2 years ago and still have several surgeries to go on my right leg. Doctors have estimated a 12-18 month window left in surgeries alone not including rehab after so stated surgeries. Why was my med-board started 10 months ago and disability rating already being discussed if there are still ongoing factors which will change the end result? It seems redundant if I'm just going to have to continue to update my med-board file. Why not just wait until all surgeries are over with and do the med-board during the final rehab process?

Thank you
MHS Web at 2008-11-19 13:47:54 wrote:

Welcome! The Webhall is now open for your questions and comments.
Arash Habibzadeh at 2008-11-19 13:52:47 wrote:

Interested in the topic!
Michael A. Parker at 2008-11-19 14:02:08 wrote:

November being warrior care month, DoD and the Services have posted much about their successes in improving wounded warrior care and benefits. Credit is certainly due for these improvements. However, I need to point out where DoD and the Services are still egregiously failing the wounded warrior.

You can about many of the remaining problems in a brief here: http://www.usni.org/assets/stories/woundedwarriorforumbrieffinalappt19972003.ppt

Some key, remaining problem areas are:

1. Medical evaluation boards are refusing to cover all current medical conditions as required by DoDI 1332.38. This coupled with inadequate documentation and substandard work ups for the conditions that are addressed leads to bad MEB’s. Bad MEB’s lead to bad PEB’s and that results in wounded warriors being denied their full and legally due disability benefits.

2. The Services are still administratively discharging members for medical conditions that are required to evaluated and compensated by the Disability Evaluation System. Most egregiously, the Navy and Marines continue to administratively discharge members due to medical conditions the PEB found not to be unfitting. This is nothing more than a scam to avoid paying legally due disability benefits.

3. The review board process has been bastardized by DoD and the Services to keep appeals and benefits down. While DoD and the services have made progress to fix the present and future, they are turning a blind eye and have even sabotaged efforts and methods to correct past disability cases.

The last Item I will discuss in detail on this post and I hope to have other post on the other two issues.

For years and years, DoD and the Services ignored the law and rated service members’ unfitting disabilities how they wanted instead of per the VASRD, a requirement that is well established in statute and case law. This is one of the key scandals revealed in the Walter Reed story and it was addressed by the various commission findings. DoD and the Services also used many other techniques to keep ratings low, like cherry picking which conditions to deem unfitting and declaring that conditions existed prior to service without overcoming the presumption that the condition is service connected.

Congress acted swiftly and reinforced the VASRD rating requirement. They also established the Physical Disability Board of Review (PDBR). Congress stated the PDBR was required to review the “Disability Determination” given by the PEB to make sure it was compliant with law, regulation and policy. DoD immediately redefined the law and stated they would only look at the rating determination. DoD also “decided” they would not address the other problems in the PEB’s “Disability Determination”, such as cherry picking, or improper MEB’s; issues that led to so many service members being denied legally disability benefits. Then DoD had the nerve to state the PDBR only had to follow the VASRD rating standards for cases adjudicated by the PEB since January 2008. For cases prior to that, DoD will follow DoDI 1332.39, a document that lead to lower ratings by illegally substituted DoD rating criteria for VASRD rating criteria. Since at least 1949, the law has specifically required DoD to rate unfitting disabilities per the VASRD criteria. DoD further “decided” that those who seek relief from their Service’s Board for the Correction of Military records cannot have access to the PDBR despite the fact that Congress made no such limitation in the PDBR law. (Doesn’t it make sense to allow members to resolve the issue at the Service level boards before appealing to the DoD level PDBR?) Finally, DoD “decided” that if the PDBR determined that the PEB “erred” in the rating, they would not make retroactive payments based on the correct rating. This is an absolutely incredible disregard for the needs of the wounded warrior to save bucks for their other “priorities”.

Please note what DoD’s own regulation states as it is verbatim from what PDBR law states:

From DoDI

5. SECRETARIES OF THE MILITARY DEPARTMENTS. The Secretaries of the Military Departments shall:



g. Correct the military records of individuals covered by section 2 of Enclosure 3 in accordance with a recommendation made by the PDBR, as outlined in section 6 of Enclosure 3, if the recommendation is accepted by the Secretary concerned.

(1) Any such correction may be made effective as of the effective date of the action taken on the report of the Military Department PEB to which such recommendation relates.



Despite Congress allowing the Service secretaries to pay benefits retroactively, DoD has decided to remove that authority from the Service secretaries and prohibit retroactive payments for DoD’s past actions that denied disability benefits. This coupled with the fact that DoD was required by Congress to have the PDBR operational by 28 April 2008, show DoD’s true benfits denying colors. They have stacked the deck do that the longer they delay getting the PDBR up and running, the less benefits they will have to pay to wounded warriors. How convenient and how despicable is that?

DoD cannot honestly state wounded warrior is their second highest priority when they pull crap like this. They have gotten away with years and years of illegally denying disability benefits and, despite promises of reform, the old “budget first, soldier last, culture remains alive and well.

On 26 October I wrote about this issue here: http://www.health.mil/Press/Release.aspx?ID=388

I was promised a response would be posted. It is now three plus weeks later and nothing. Why won’t DoD address these issue openly and honestly?

Agian, I encourage you to read my brief at http://www.usni.org/assets/stories/woundedwarriorforumbrieffinalappt19972003.ppt

to understand how much more DoD must do before they can honestly state they are doing everything they can for the wounded warrior. I have given this brief and related information to DoD time and time again and yet they refuse to act or even respond to the points raised. They have proven time and time again that they are really not acting in the best interest of wounded warriors.

Michael Parker
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