Sunday, April 13, 2014

Soldiers stuck in backlogged disability system can't go forward, can't go back


Sgt. Chris Peden is stuck. The Joint Base Lewis-McChord soldier is spending his last months in the Army too damaged to be the gung-ho paratrooper of his first Iraq deployment but not ill enough to be cut loose from his enlistment with his Stryker brigade.


He’s in the limbo of a disability system the Defense Department created seven years ago with good intentions. It was designed to make sure wounded service members smoothly enroll for veterans benefits and start receiving checks within a month of leaving uniform.


For Peden, the downside comes in the hundreds of days he’s had to continue showing up at battalion headquarters even though he can’t concentrate, struggles with mood swings and has physical injuries that slow him. With little to do because he can’t handle much responsibility, he sometimes passes the time playing games on his cellphone.


“I can’t do what I used to do. I’m not capable,” said Peden, 32, a Tacoma resident diagnosed with post-traumatic stress disorder and who endured several head injuries early in his military service.


A year and a half ago, he was sent home early from a Stryker tour in Afghanistan.


“My brain literally just doesn’t work the way it used to,” he said.


He is among about 700 soldiers in Lewis-McChord’s 7th Infantry Division who are leaving the Army for medical reasons through a joint Defense Department and Veterans Affairs program known as the Integrated Disability Evaluation System.


The IDES process is supposed to take 295 days from the time the Army begins considering a soldier for an early medical retirement to the day that soldier starts receiving VA benefits.


But the military and the VA have yet to hit the deadlines they set in 2007 when they laid the groundwork for the program. The average time soldiers spend in the system sits just shy of 400 days — about 3½ months longer than the target.


Altogether, that makes more than a year of waiting in uniform for soldiers who know they can’t continue their military careers.


“Why would you force a soldier to be in a unit when there’s not a job for him and you’ve already determined he can’t do the job?” Peden said.


The IDES system is used by all of the Armed Forces, but the Army is its biggest component because of the heavy toll the wars in Iraq and Afghanistan took on the nation’s ground forces.


The Army and the VA say they’re now swiftly making up ground on a backlog of IDES cases that accumulated in years when the system enrolled thousands more cases than it completed.


In 2011, for instance, the system enrolled 18,651 military service members but finished just 7,106 cases, according to a 2012 Government Accountability Office report.


Now, the Army and the VA are starting to finish more cases than they start each month, said Col. Carl Johnson, chief of the Army’s Physical Disability Agency.


Last year, the Army alone accounted for 22,037 new cases. The service completed 23,432 cases.


Johnson considers the trend a good sign for the program.


“We’re on track to break the back of this backlog,” he said.


A long process


The military and the VA have a shared responsibility in getting soldiers out of uniform and into the benefits they’ve earned.


First, the military considers whether a service member is well enough to continue his or her career. That’s called a medical evaluation board.


If the individual is deemed no longer fit for duty, the process moves into another phase in which the Defense Department and the VA set the person’s disability ratings. This is called a physical evaluation board, and it determines what kind of compensation veterans will receive for their service-connected injuries.


In the third phase, known as the transition, troops receiving medical retirements can begin to take leave from their units and focus on ironing out their VA benefits.


In the last phase, called reintegration, medically retired troops begin receiving their VA disability checks. They’re supposed to receive those checks within 30 days of their last day in uniform. So far, the average wait is 57 days, a VA official said.


A slow disability process not only frustrates soldiers in the system, but also ground-level commanders. They want wounded or injured troops to separate from the military with their benefits, both for the sake of the veteran and for the wellbeing of the unit so that healthy, deployable soldiers can fill open positions.


“We are working very hard on making sure that we are doing everything on our side … to help soldiers get through the system, get through the process and make sure those who are transitioning do so with dignity and respect,” 7th Infantry Division surgeon Col. Mike Oshiki said.


Leadership


Lewis-McChord’s six main combat brigades got serious about speeding their role in the disability process a year and a half ago when the Army launched the 7th Infantry Division headquarters at the base. That office came with oversight from then-Maj. Gen. Stephen Lanza, who has since been promoted at Lewis-McChord.


With a two-star general pushing for changes, the division handed down new guidance to officers and noncommissioned leaders.


Captains and first sergeants now attend courses on managing IDES cases. Patients receive guidebooks and early preparation for their transition to civilian life.


Commanders are responsible for writing statements that weigh on disability decisions. They also help ensure that soldiers in line for medical retirements make their appointments.


Recently, the Army added a couple extra features to the system so cases move faster and soldiers have a better sense of when they’ll leave the military.


One allows brigade and division commanders to contact the Army’s Physical Disability Agency to check on specific cases. Those officers are colonels or generals with enough rank to set priorities.


Another lets soldiers in the system check their own status and gives them an estimate of when their cases will be complete.


“It allows soldiers a chance to plan,” Johnson said. “It calms them.”


Technology


Also, as of last year, the Army and the VA are using electronic records and electronic transmission, instead of paper and the Postal Service, when they exchange documents to move a case forward.


Now, only 1 percent of IDES cases in the 7th Infantry Division are considered late. The Army as a whole is meeting its deadlines, Johnson said.


But the backlog persists. In 2011, when the Defense Department initiated 11,000 more IDES cases than it completed, soldiers were in the process for 395 days. Today they’re usually in it for 397.


“We got rid of our backlog, but when you do that — this is a linear process — and our backlog has moved on to the VA,” Johnson said.


All IDES claims are processed at a VA office in Seattle, which recently added 36 employees. It has 165 people working exclusively on these cases, said Mike McNeal, director of the Veterans Benefits Administration/Department of Defense program office.


He and Johnson believe the additional staff and heightened Army focus will lead to the system working as intended by later this year.


Skeptics who have watched the claims backlog grow year after year say the VA should be moving faster by now. They say the long wait and uncertain outcomes put stress on vulnerable military families.


“Being left in limbo in that system can be really challenging,” said Jackie Maffucci, a research director for Iraq and Afghanistan Veterans of America.


Two years


Peden is nearing the end of his disability process. This month, he received his final ratings from the VA and the Army.


He expects to be able to start taking leave from his unit for good by about June, and he should finish the entire process by November at the latest.


His long road to leaving the Army began in October 2012 when his Stryker company sent him home early from Afghanistan because soldiers around him noticed he was moody and having trouble focusing. It was his third combat deployment since he enlisted in 2006.


“I was losing my mind. Somebody probably was going to get hurt,” he said.


Peden returned to Lewis-McChord for a temporary posting to the base’s Warrior Transition Battalion, a medical unit that focuses on soldiers with long-term care needs for physical injuries or behavioral health diagnoses.


He did not get to stay in the battalion. He returned to his unit, where he held some responsibilities keeping an eye on soldiers assigned to its rear detachment.


In February 2013, when the rest of his Stryker teammates were coming home from the war, the Army sent Peden to an inpatient facility in Portland where veterans can work on post-traumatic stress or addictions.


He spent a month there and felt he improved because of the opportunity he got to focus on his health.


After the therapy, the Army sent Peden back to his Stryker unit, A Company of the 4th Battalion, 23rd Infantry Regiment.


He believes the move unraveled the gains he’d made in Portland.


The same anger and attention issues that troubled him in Afghanistan started upsetting him again. He’d feel rage and remove himself from the building to sit in his car until it passed.


He kept reliving traumatic events from his 2007 deployment in Iraq with the 82nd Airborne Division. He was close to several explosions on that tour, including a mortar blast that punctured his chest with shrapnel.


Years later, he’d think about soldiers he knew who died in combat or committed suicide after they came home.


“It’s like a ferris wheel. Every seat on the ferris wheel is a bad memory,” he said.


Seeking help


Peden’s condition deteriorated last spring and summer, climaxing with a suicide attempt in August. His wife, Karen, talked him out of it.


In late 2013, Peden’s unit tried to get him reassigned to the Warrior Transition Battalion. The soldiers around him thought he’d get better care if he was in that unit again.


“Sgt. Peden suffers from insomnia, irritability, memory loss and bad anxiety from multiple direct explosions from his first deployment. These symptoms have impacted his ability to make decisions,” wrote his company commander, Capt. Jarrod Harris, in the Warrior Transition Battalion application.


A committee of commanders and Army doctors considers applications to the warrior unit in weekly meetings. It chose not to admit Peden.


Karen Peden called The News Tribune after her husband’s rejection from that reassignment. The denial conveyed to them that they’d have to face the soldier’s turmoil on their own.


Today, the couple is looking forward to moving on once his IDES application is complete.


One day, Peden would like to go into business for himself. First, he hopes to spend about a year after leaving the military learning to live with his PTSD and head injuries.


“I wish I could take a vacation from myself,” he said. “You live with it every day. Every minute of the day. It doesn’t stop.”



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