By Tom Philpott, Special to Stars and StripesSeptember 23, 2009
Vietnam War veterans will nod with understanding over many of Noel Koch's comments contrasting support for wounded troops and veterans today, from citizenry and government, compared to how it was 40 years ago.
During the Vietnam War, he said, "we got very good at saving people's lives on the battlefield. But we never got good at giving them a life worth living once they got back here," Koch said. "We just warehoused them in VA hospitals and that's part of the scandal of the times."
"We're not going to let that happen again," he continued. "And that's a directive that comes from the president - and I should say the first lady as well - and runs in a straight line, with the secretary of defense straddling it, right into this office."
Koch is director of the Department of Defense's Office of Transition Policy and Care Coordination (TPCC), an entity less than a year old. He's responsible for how well DOD and the services implement very ambitious initiatives and reforms to ensure this generation of warriors gets the support it needs to stay in service or move as smoothly as possible into civilian life.
At the risk of personalizing the issue too much, Koch said, he noted he's a member of Vietnam Veterans of America.
"And our basic motto is never again will one generation of veterans abandon another. You may take from that a certain sense of grievance," he said, "but that's not the important part. The important part is this: that (Vietnam) generation is determined to take care of this generation."
In the wake of the scandal that rocked Walter Reed Army Medical Center more than two years ago, several commissions and internal studies produced mounds of recommendations to improve support of wounded warriors. Seemingly before the ink dried on commission draft reports, Congress had passed comprehensive wounded warrior legislation.
Meanwhile, the departments of Defense and Veterans Affairs jointly established the Wounded, Ill and Injured Senior Oversight Committee (SOC), co-chaired by the deputy secretaries of VA and DOD. The SOC was to ensure that wounded warrior legislation was implemented properly and that key task force recommendations were adopted and resourced.
The spotlight has dimmed, SOC survives but, within DOD, it's Koch's TPCC office, with a staff of 30 and rising, taking over day-to-day oversight of dramatic warrior transition reforms. Here's a rundown from our interview with Koch (pronounced Cook) in his Alexandria, Va., office:
Disability Evaluation System (DES) pilot. Jointly administered by DOD and VA, the pilot now is running at 21 military hospitals. It gives ill or injured servicemembers a faster, more seamless disability review and rating process with results recognized by both departments. The pilot will expand soon to seven more military treatment facilities, enough so that half of all service disability evaluations will be done in the streamlined system.
Since November 2007, nearly 4,000 servicemembers have enrolled in the pilot. Through August this year, 534 members had completed the process. Nearly half have been awarded disability retirement, the result of stricter adherence to more liberal VA rating rules and higher ratings for Post-Traumatic Stress Disorder. Thirty-eight percent are returning to duty. Only 13 percent, so far, have been separated, most with a lump sum severance.
Under the legacy system, DOD and VA each conducted their own physicals and do their own ratings. It takes an average 540 days to complete. The pilot effectively cuts that time in half. On average, the pilot is taking 273 days to complete, from enrollment until the member has a VA benefit decision in hand. Koch said the pilot is popular with participants.
Recovery Care Coordinators. The Army still calls them Wounded Warrior Advocates. To Marines, they're members of the Wounded Warrior Regiment. To Koch and his staff, they are Recovery Care Coordinators or RCCs, managing the non-medical care of war wounded until they recover or are separated or retired. Often the contact doesn't stop then. Marines, for example, try to maintain contact with all of their seriously wounded vets to ensure they're getting the support they deserve.
Koch's office is setting standards for RCCs and conducting training.
"We're in a very unique situation with these wars," Koch said. "We're trying to take care of people in a way we never did before."
Physical Disability Board of Review. Koch's shop oversees the PDBR. Under a law passed two years ago, as many as 77,000 veterans separated since 9/11 with disability ratings up to 20 percent are eligible to have ratings reconsidered and, perhaps, upgraded if their Physical Evaluation Board didn't use the more liberal VA rating schedule in effect at separation. A rating of 30 percent or higher means disability retirement, rather than a lump-sum severance, and Tricare eligibility for veteran and family.
The DES pilot, the PDBR and the RCC, Koch said, all show "we're trying to do things differently."