Agencies look at revamping medical boards
September 19, 2008
WASHINGTON (Army News Service, Sept. 19, 2008) -- Some 400 representatives from the Army, Department of Veterans Affairs, Department of Labor and Social Security Administration, among others, are meeting in Leesburg, Va., this week to discuss ways to improve the care of wounded and ill Soldiers.
Many of the discussions have centered on revamping the Medical Evaluation Board process by which wounded and ill Soldiers are screened to determine whether or not they're fit to continue to serve, said Brig. Gen. Gary Cheek, the Army's assistant surgeon general for Warrior Care and Transition.
"Members of the MEB determine whether or not a Soldier is fit or unfit for service," Cheek said. "Then, the Soldier goes before a Physical Evaluation Board, which gives him a disability rating." Because of the two processes, "there's confusion and duplication of effort," he said, adding "We need to get the military completely out of the disability process and allow the Veterans Administration to be a single source of benefits."
Today military medical experts are saving Soldiers' lives on the battlefield, evacuating them quickly to Landstuhl Regional Medical Center in Germany and Walter Reed Army Medical Center in Washington, D.C., and others, to receive the best care possible. Then, those same medical professionals who saved the Soldier are making evaluations as to whether or not the Soldier should be retired from duty. They go from being angels "to being the enemy," Cheek said.
In July, the Army chief of staff issued a message to Army leaders indicating there had been "an explosion of Soldiers in warrior transition units" over the 16-month period since the WTUs were created - from some 5,000 to 12,000, said Lt. Col. Michael Mixen, chief of Plans and Policy for the Warrior Care and Transition Office.
"The numbers were way up," Cheek said. Simultaneously, WTU cadre were rotating out of the WTUs for other assignments. Suddenly, there were too few people caring for too many Soldiers.
The Army's then-vice chief of staff, Gen. Richard Cody, sent a message to Army leaders advising them to fix problems as quickly as possible, Mixen said.
Attendess at the WCTO conference focused on the VCSA's imperatives, Cheek said, including "right-sizing" the WTUs to ensure the right Soldiers were being assigned to the units - those who were expected to require at least six months of rehabilitation; that there was an appropriate number of cadre to support them; and that Soldiers received orders assigning them to the WTUs in a timely manner.
Commanders were also briefed on "a comprehensive Army mental-health strategy, which is to be announced at this year's AUSA [Association of the U.S. Army] conference [in Washington, D.C.], in October," Mixen said.
Discussion groups addressed whether or not the Army has enough available doctors in specific specialties to care for Soldiers, and they talked about developing a comprehensive plan to help Soldiers transition from medical rehabilitation to civilian life, developing Soldiers' life skills and occupational skills to provide them the best chances for future success.
Great strides have been made since the WCTO was established some 19 months ago, Cheek said.
"We tend to focus on the negative, but in a little more than a year and a half we've gone from no focus on warrior care to an organization of 35 separate, fully staffed groups.
Recent changes include the addition of retention NCOs as part of WTUs, to encourage Soldiers who want to remain on active duty to stay in service or enter the reserve component.
Personnel NCOs from brigades, battalions and companies who support the WTUs have been trained on the different types of computer software used to track and record the care of warriors in transition, Mixen said
Additionally, retired Gen. Frederick Franks Jr. -- former commander of Training and Doctrine Command and also of VII Corps during the first Gulf War -- has been hired to conduct an external review of the MEB process, Mixen added.
Meantime, Army leaders are looking at ways to get current legislation governing the MEB process changed, to transition it from the Army to the VA.
Lt. Col. Marie Dominguez, special assistant to the secretary of veteran's affairs at the VA's central office in Washington, D.C., is among the many people working to improve the MEB process. One of the recommendations is to have a physician complete a profile of the Soldier to determine whether or not he's ready to begin the MEB process.
Under the current system, a subspecialist [in a particular medical field] now writes a profile for one condition, when the Soldier may well be suffering from several conditions, Dominguez said. The MEB process is slow today because the starting time isn't appropriate. "Sometimes it bleeds into the Soldier's rehabilitation/treatment phase; it's started too soon."
"The ideas we discuss this week will go into a report for consideration for implementation by Army leaders and could be forwarded to Congress in order to change the big impediments - the 'rocks' - to the MEB process," Cheek concluded.
Until then, medical facilities across the Army are working to streamline their own MEB processes.
At Fort Bragg, N.C., Womack Army Medical Center personnel are reducing the number of medical-evaluation boards to support wounded and ill Soldiers, according to Lt. Col. Niel Johnson, chief of the Department of Deployment Health.