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Military Disability System Making Progress, Still Falling Short Of Goals

Courtesy Sgt. Koetje

For soldiers who are injured or wounded, the process for determining whether they’re eligible for medical retirement is long.

Many, including the Government Accountability Office, say too long.

In a 2012 report to the Senate Veterans Affairs Committee, the GAO found that soldiers at Washington’s Joint Base Lewis-McChord and other military installations were waiting nearly 400 days to get through the system.

Rating A Soldier

Currently 2,100 injured soldiers from JBLM are going through the evaluation process.

The disability rating a soldier receives determines their benefit payment from Veterans Affairs after they’re discharged. Nationally, there are 26,000 soldiers going through the process, up from 22,000 a year ago.

[asset-pullquotes[{"quote": "To be perfectly honest, I feel like I've done my share and then some for the Army at this point.", "style": "inset"}]]Sgt. Jake Koetje is one of 80 soldiers in the 17th Fires Brigade at JBLM undergoing the medical board and determination process. After 12 years in the military, Koetje is eager to get out and move on. “To be perfectly honest, I feel like I’ve done my share and then some for the Army at this point," he said.

The complex formula that determines a soldier’s disability benefit relies on input from doctors, commanders and the Veterans Administration.

A 2012 Army Inspector General report examining the Integrated Disability Evaluation System (IDES) called out company commanders for submitting incomplete assessments of how a soldier’s condition impacts their ability to perform their job.

Maj. Gen. Stephen R. Lanza is commanding general of more than 22,000 troops that make up Joint Base Lewis-McChord’s 7th Infantry Division. Lanza says company commanders now have additional training that stresses the importance of doing accurate and thoughtful assessments for soldiers in their charge. Lanza said new accountability has brought down wait times in his division. “We’ve been able to do that because from our perspective this has been about leader engagement. This has been about commanders taking charge of the program," he said.

[asset-pullquotes[{"quote": "I'll be perfectly frank, this is not an easy process.", "style": "inset"}]]Lanza says in 2012 the division had 183 soldiers in the process over 100 days, which is the goal set for the Medical Evaluation Board portion of IDES. Right now he says that’s down to 16. “I’ll be perfectly frank, this is not an easy process," Lanza said.

Emotionally Challenging System

It's also rather new to JBLM.

In 2007 the Army and the Department of Veterans Affairs combined two long, cumbersome medical evaluation and ratings systems into one. The effort is supposed to move a service member seamlessly through a four-stage evaluation, determination and benefit award process in 295 days. The IDES has been in use at JBLM since 2010.

[asset-images[{"caption": "In 2007, the Army and VA combined two separate rating systems into one. The full roll-out of this program was not completed until 2011, which accounts for the significant jump in IDES cases between 2010 and 2011. A case is considered resolved when either completed or if the soldier returns to active duty (rare). ", "fid": "5022", "style": "placed_wide", "uri": "public://201307/DataVis-MilDisability.gif", "attribution": "Credit KUOW/Kara McDermott"}]]

The disability process can be challenging emotionally for soldiers and their families.

Most injured soldiers are dealing with chronic pain. Some have traumatic brain injury. At least six soldiers have committed suicide while going through the disability process at JBLM.

[asset-pullquotes[{"quote": "It's upsetting when people when people don't take me seriously and think I'm trying to get something for free.", "style": "inset"}]]Sgt. Koetje is being rated for a shoulder injury and post-traumatic stress disorder. Koetje says he felt like he had to fight to get Army doctors to pay attention to him. “It’s upsetting when people don’t take me seriously and think I’m trying to get something for free whatever the case is. I know my body and what’s wrong and I’ve got a pretty good idea of what’s going on with me."

The high numbers of soldiers going through the disability process have strained medical clinics and providers at Madigan Army Medical Center. Last year, the average time soldiers were spending in medical evaluation portion of IDES was 208 days, more than double time they’re supposed to.  

In an effort to lower wait time and ease the process for soldiers and medical providers, the hospital has hired additional staff and opened a satellite clinic on base. The Soldier Center Medical Home provides injured troop members access to medical care, physical therapy and behavioral health services. 

Soldiers rely on Physical Evaluation Board Liaison Officers, or PEBLOs, to help them navigate and understand the disability process. Madigan has 40 PEBLOs. Last year they had 13.  

[asset-pullquotes[{"quote": "It's good to have someone to fight the battles that I can't.", "style": "inset"}]]Sgt. Koetje says his PEBLO keeps him up to date about the progress of his case, and when he was concerned about how doctors were portraying his case in his medical narrative, his PEBLO was able to advise on how to appeal. “It’s good to have someone to fight the battles that I can’t," he said.

But not all PEBLOs are equally competent. And that can have a direct impact on soldiers and their families.

Benefit Delays

Keith Curry was in the Army for a decade. He was recently medically retired due to injuries he sustained while deployed to Iraq. It took him a year to get through the system.

Curry says after he received his discharge papers he was surprised to learn from the VA that it would be at least four months before he received a disability payment. “I’ve always been very responsible with my finances; so is my wife. Every day we’re running around kind of balancing a string, you know? Trying to give our kids the illusion that everything’s OK, and it’s not OK. It’s far from OK," he said.

Curry and his wife and five children are temporarily living with friends in Lacey. He says he’s hopeful his retirement pay will kick in next month, but it won’t be enough to cover the bills.

The VA says the length of the delay that the Currys are experiencing is exceptional. Department of Veterans Affairs' Danny Pummill says as the Army has become more efficient in moving soldiers through the process, it's created a disability claims backlog on their end. On average, he says, soldiers are waiting about 77 days to receive benefits.

The VA hopes to get that down to 30 days by October. “That is our goal. That’s what we’re striving to get. We’re not quite there yet because this is very complex," Pummill said.

Pummill says the administration recently hired 125 people at VA Puget Sound to help with the problem.

[asset-pullquotes[{"quote": "I think we underestimated how much is going on in the lives of these men and women.", "style": "inset"}]]The reality of a claims backlog is one thing, but getting that information to soldiers so they can emotionally and financially prepare is another. Pummill acknowledges that the message regarding the delay doesn’t always make it through to soldiers.

“I think we can do a better job," Pummill said. "I think we underestimated how much is going on in the lives of these men and women. We’ve got to get a lot more detail into the briefings we’re giving to these kids.”

Sgt. Jake Koetje’s physical injuries and post-traumatic stress will end his 12-year military career. Like many service members, it’s a job that required him to be willing to give his life. It makes it hard, he says, to accept the seeming dispassion of the bureaucracy that will determine his financial future. “My case and however many pages in a portfolio thing somewhere, going across some guy's desk who’s never met me and can’t even pronounce my name — I find that kind of unfair," he says.

Koetje hopes to be medically retired in the next two weeks.