Wounded soldiers swamp Army’s disability system

WASHINGTON – The thousands of soldiers wounded in the wars in Iraq and Afghanistan have overwhelmed the Army’s system for evaluating their eligibility for disability benefits, leading to a near-total failure to complete such reviews in a timely manner, the service’s inspector general concluded in a report released Monday.

The report also found medical “hold” facilities lacked critical staff and formalized training for personnel caring for wounded soldiers, with more than half of unit commanders reporting inadequate staffing. It also cited inadequate and unreliable databases for tracking the wounded.

At some facilities, a lack of wheelchair access – in violation of the Americans With Disabilities Act – meant wounded soldiers had difficulty reaching restrooms.

One facility had ramps, but also a gravel parking lot and no sidewalks, “making it nearly impossible for soldiers in wheelchairs and difficult for soldiers using crutches and canes to access the building” without help, the report said.

More than 25,000 service members have been wounded in the two wars, nearly half of them seriously enough that they cannot return to duty within 72 hours.

Delays in the Army’s rating of disabilities have been a source of deep frustration for many, with wounded soldiers waiting to move on with their lives outside the military.

Problems with that rating system are pervasive, the report found, particularly in meeting time standards for processing cases.

In more than 90 percent of cases, for example, the Army failed to meet its 40-day time limit for completing physical evaluation boards, as the number of cases increased from 9,000 in 2001 to more than 15,000 in 2005, the report found.

And in 43 percent of cases, the Army did not meet the 30-day goal for processing medical evaluation boards, as those cases grew from 6,560 in 2002 to 11,000 in 2006.

The Army had only 30 people assigned to manage all the physical evaluation boards, even though the organizations cited an overwhelming need for support staff, according to the report.

They did not receive funding to hire more people, however, and thus relied on “ad hoc manpower” agreements, including with contractors.

Such issues “diminish the ability of the evaluation system to meet the needs of soldiers,” the inspector general, Lt. Gen. Stanley Green, stated in a memo on the report.

The investigation, ordered last April by former Army Secretary Francis Harvey and completed March 6, involved interviews with 650 soldiers, civilians and leaders at 32 Army posts in the United States and overseas.

Seventy percent of the medical hold unit leaders reported they did not have adequate personnel assigned, affecting their ability to “provide soldiers the level of attention and support they required to complete their medical care,” the report said.

More than half said their staffing was “inadequate for them to execute their mission.”

Especially worrisome, the medical hold commanders reported, was the lack of behavioral health specialists who could help identify soldiers with depression, post-traumatic stress disorder or suicidal behavior.

The need for such specialists was underscored in a study published Monday in the American Medical Association’s Archives of Internal Medicine.

It said that 25 percent of Iraq and Afghanistan war veterans seen at Veterans Affairs health-care facilities were found to have mental health problems, and an additional 6 percent had “psychosocial or behavioral problems.”