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Physical Evaluation Boards.

From the LA Times, the tale of Sergeant Baumann:

FT. LEWIS, WASH. — A sniper shot Sgt. Joe Baumann on a Baghdad street in April 2005. The AK-47 round ripped through his midsection, ricocheted off his Kevlar vest and shredded his abdomen.

The bullet also ignited tracer rounds in the magazine on his belt, setting Baumann on fire.

Almost two years later, the 22-year-old California National Guard soldier from Petaluma, walks with a cane, suffers from back problems and has been diagnosed with post-traumatic stress disorder that keeps him from sleeping and holding a job.

"He can't even go to the grocery store by himself," said his wife, Aileen, also 22.

The question pending before a military review board at this big Army post south of Tacoma is whether to grant Baumann a military disability pension and healthcare or simply cut him an $8,000 check for his troubles.

Seems like a slam-dunk, right?

In a preliminary ruling last month, the three-officer Physical Evaluation Board that is reviewing Baumann's case decided for the severance check, rating his disability at only 20% and characterizing his post-traumatic stress disorder as "anxiety disorder and depression."

The people (including two officers who Baumann worked for in Iraq) helping Sergeant Baumann make a cogent observation:

"The system was designed for a peacetime Army to ferret out malingerers," Clark said, "but they haven't updated it to accommodate the huge influx of wounded soldiers. Sgt. Baumann is no longer physically or, at this point, mentally fit to go to war. I believe he deserves the full retirement."

Sergeant Baumann faces the same choices I faced when I was determined medically boardable...

If he accepted the $8,000, Baumann still would be eligible to apply for Veterans Affairs disability benefits. But VA benefits do not include retirement pay, family healthcare, and military post exchange and commissary privileges. In what many soldiers regard as the ultimate Catch-22, if he were accepted by the VA, he would have to pay the Army's $8,000 back.

The huge difference between Sergeant Baumann and myself, *aside* from my status as a field grade officer, was that I was going to be eligible for regular retirement while the board process was going on.

As I already had my retirement papers submitted, the medical types reluctantly chose to not recommend me for the board. Reluctant? Their concern was that if they didn't, I could pull my retirement (true enough) and sneak past the system.

The board would have been a crapshoot.

The VA eventually rated me (after taking two years to get it done) at 70%. VA ratings and PEB ratings don't often map to one another. VA uses different criteria. The Army might have rated me at 30%. Still enough for a disability retirement... but at less than the 50% I would get with a regular retirement. They might also have gone as high as 70%, which would have given me more money in my retirement than what I got with my regular retirement... But I wouldn't be eligible for the VA payments then, either. The other thing with a disability retirement is that you are subject to recall and re-evaluation. If you got better, 10 years down the road you could possibly find yourself back on active duty... too bad about that life you'd built (not that IRR reservists aren't suffering that now for a different reason) And oh, by the way, because I went the VA route, and retired from the Service as a Regular - since my retired pay was greater than my VA payment, the VA payment was deducted from my retired pay. The net result of that was that all I got was a tax advantage from the reduction in taxable income.

Got that? Clear to you?

Since then, the pay offset was repealed... over a 10 year phase in. Which means that I do now get less of my pay withheld from my retirement check, and my VA payment is only partially funded by me. In seven more years, the two will be completely separate.

Now, I could possibly get more, right now, by applying to have my disabilities apportioned out to those that are combat or combat-training related. If I were to go through that process, I might, *might* get more up front than I am currently.

But I don't wanna go through the hassle, and my life right now is such that I can afford to make that decision.

What's my point? I'm a relatively senior officer. I have a Masters+ education. I do complicated work for my employer. And I found the process confusing and daunting. I function as the unofficial local advisor to my fellow retirees going through this process, almost all of whom are people like me, and it takes hours sometimes to explain this whole thing to them.

So you can imagine what it's like for a wounded junior soldier, who may *also* have the debilitative effects of PTSD affecting her decision-making processes. And who doesn't have the safety net of a regular retirement available to her. Or him. Or people like Sergeant Baumann's former leaders to go to bat for him.

"The system was designed for a peacetime Army to ferret out malingerers," Clark said, "but they haven't updated it to accommodate the huge influx of wounded soldiers. Sgt. Baumann is no longer physically or, at this point, mentally fit to go to war. I believe he deserves the full retirement."



John - Here's another place where you could lend your leadership, if they would recall you. Too much bureaucratic bs, too little concern for the soldier. Can it be mitigated by caring people, or is the system so screwed up that just replacing the people won't help?
I think Barb is right a point. I don't think Leadership is the only answer, just part of the equation. Part of it, in my opinion anyway, can't be fixed. And thats the part we're, as the old quote goes "The bureaucracy is expanding to meet the needs of the ever expanding bureaucracy" Between the government regulation, military desire for accountability, and the numerous military, civilian, and HIPA regulations, we've created a red tape monster than in the end no one wants to take responsibility for the simple practice of making a decision Everyone has become so Politically/Politically Correct/Equal Opportunity/Equal Rights/Not Meeting the Needs/Ignoring the Little People Gun shy that the anti thesis has become true....they just ignore almost everybody. It's almost like some deranged Joseph Heller novel gone horribly wrong. But I'm getting cynical, but I think a large portion of the onus is not just leadership, but in way we (as in the military/government) do basic business. If you want more on my opinion you'll need to fill out a BSForm 23-Ab and be sure to sign blocks 4a and 23z and be aware we can reject your request for any purpose including wearing the wrong color socks when you fill it out. If we reject your request you'll need to fill out a TECH Form -331H to request permission to refile the previously mentioned form. Please be sure to list all information including your dog Scruffy you had when you were 5 date of birth. We will handle your process in the order in which it was received and approve it the next 3 to 4 million light years or the day after Leap Day, which ever comes first. Thanks for shopping.
Actually, Bloodspite, I was not thinking of the leadership ... or at least not only that. I was just thinking of bored/stupid bureaucratic worker bees who use the rules as a form of weapon, instead of finding the path of best results for the soldier. So, I agree with you :-) And I suspect that since I have on grey socks today, my form BSForm 23-Ab is now useless and I must begin the process all over again. Which would be funnier if it were not true.
Well, I know I'm going to get smacked down for this, but it needs to be said... Malingering is not a peace time only problem. Right now pretty much all you need to do to get diagnosed for PTSD is say you have it. When we were given our debrief at Ft Dix coming back from Kuwait a couple years ago we were encouraged to abuse the Vocational Rehab program. Really. We were told to file for any injury, twisted ankle, anything, so we would be eligable for those benefits. (Vocational Rehab is supposed to be for people whos injuries require adaptive assistance and job retraining.) I was pretty offended at the intended misuse of the system, but I'm sure others didn't mind. Right now there's talk in the VA of automatically granting any OIF/OEF veterans 30% if they apply with no proof of injury. Then they can come back in 5 years and decided whether it was justified. Great use of our tax dollars, right? I'm sure no WWII, Korea or Viet Nam Vets are going to have any problem with that. And certainly there won't be any abuses of that once the word gets out. Don't get me wrong - I'm all for injured vets getting the treatment and benefits they rate promptly and with a minimal amount of hassle, but there's a reason all that paperwork exist. Soldiers aren't all noble heroes because they deployed, they're human being who range from the best the country has to offer to absolute snakes who will take advantage of any situation. So how do we get all the abuse out of the system? I don't know. I don't think there's any shortage of caring people in these medical system, I think the problem is more bureacratic in nature... Disclaimer: I do not now, nor have I ever worked for the VA.
A good friend of mine is a retired Army enlisted man. He has suffered the ravages of MS for years and is almost a quadriplegic. According to his wife, he's rated as being 200% disabled. If accurate, WTF? How is it possible to be 200% disabled? Is there (or was there) disability inflation going on? When I hear of seriously wounded veterans being given the run-around for medical treatment and disability care, it makes my blood boil. We OWE those people, big time.
Larry - I don't know about 200%, but there are rating levels above 100%. Part of this stems from band-aid adaptation to the changing nature of the workplace. Back when the rating system was established, most work had a large physical component to it, and the rating system reflects that bias. So some people who are perfectly employable can end up with high ratings. I do, but the cross-cut to that is that most of my rated conditions affect the cost of my day-to-day health care, frequency of need for follow-ups, and a shortened life expectancy and diminished overall quality of life. To get rated at 100% you have to be unemployable in a conventional sense, and the VA checks with SS and the IRS periodically to ensure you don't have earned income above a certain level (the threshold number escapes me at the moment). When you break into that territory, there are additional ratings that add money or services, and they relate to issues of care, generally. If I'm unemployable but pretty much able to care for myself, that's the 100% level. If I have multiple missing limbs, blindness, deafness, etc, or diseases like MS, where a helper can be required, then there are further levels above 100% that account for that - which is what your friend's wife is talking about.
Pogue - you're correct on all counts, and I got that coaching, too. Even from the VA people doing my evaluation physical - suggestions which I declined or I'd be 80%, vice 70%. That said - the point about the whole process being wrapped around peacetime considerations and timelines is still valid. And it's still very convoluted to go through by yourself, hence my point about the challenges I had. There has to be a middle ground - and I think a large part of it is wrapped up in the fact that the Institutional Army, despite protestations to the contrary, isn't really At War. Just as the nation isn't, in the sense of going to war in the past. And we need to adapt to that. Just as there are people who abuse the pay system for their benefit is no excuse for the condition of the pay system regarding RC forces five years into a war footing, so too the criticism of the PEB system - five years into a war footing. And the greatest number of victims of the health care and PEB system seems to be RC personnel - the Army needs to adapt. And it's my job. "Still Serving," remember the retiree slogan? It's my job to be a gadfly, since I have no other lever to pull. There has to be a middle ground.
John, I absolutely agree with you on that "Middle Ground" and thank you for trying to drive the system towards it. I don't mean to try and justify the problems with the system due to the abuses. I guess it's that it has become politically advantagous to beat up on the Military and VA to the point where "throw money at it" seems to be the common goal. I know that's not what you're advocating, nor do I think the Castle Denizens lean that way. I'm just frustrated watching a process that repeats every few years where the problems don't get solved, new ones get introduced.
Out of the park, John. What a stupid decision. 20%? Puhleeze. He can barely walk with assistance, has memories and needs help just to function. So, why can't the tapeworms think outside the box in this area? Are the regulations so daunting that they are afraid of...what?
Interesting that you bring this up. Sniper1 of had a blog entry today about the abhorrent conditions found at the Dallas VA Hospital. I left the following comment over there. While it's partially Dallas VA specific, it also applies here. V5 . . . I can’t speak to the conditions at the Dallas VA Hospital itself, but ever since the debacle at Walter Reed I’ve been leaving comments everywhere about how crappy the entire VA system is, especially the Secretary of Vetreans Affairs Jim Nicholson. It took me 22 very long months to get my status taken care of, from original claim through the appeals, to finally having the VA decision overturned and winning my claim. I also know veterans that are going over 40 months in their claims. In the meantime they sit and wait and suffer through mediocre care at the Washington DC Veterans Hospital, which is a sh*t-hole compared to Walter Reed. I only wish they’d send me down the road for some treatment at the Walter Reed Army Hospital complex!! It’d be like being transferred from Sadam’s spider-hole the F’n Taj-Mahal! Getting my point yet? I’m sure there are some great VA hospitals, but the one in Washington DC, and apparently Dallas too, sure as hell aren’t on the list. So, now, here I sit, assured that I’ve won my VA case, with nary a penny of awarded money in sight. But oh, wait, let me tell you how this worked. I claimed three things, all service connected: 1. Rash! A mysterious recurring rash that no military, VA, or civilian dermatoligist can figure out the cause or cure for. Sometimes it takes over my entire face, head, chest, and shoulders and looks very similar to a HUGE “Port Wine Stain” birthmark. Other times it’s non-existent. 2. Memory loss! I have HUGE tracts of brain real estate eaten up. There are large gaps in my memory. I can’t remember half of my son’s childhood, most of my miltary service, and a good portion of my K-12 school years. A lot of my life missing. The doctors think it’s part of the issue with my spinal trauma. When the damage happened the spinal cord swelled up into the lower brain and did some damage. They still don’t know the extent of all of it. 3. Quadriplegia! I’m what’s called a higher functioning quadriplegic… really no description needed, it’s not great, but I’ve gotten stronger. Well, the VA only returned a favorable decision for the quadriplegia and not the rash and memory loss. That’s fine with me, the quadriplegia is/was the most complicating issue. However, the “denial” letter for the rash and memory loss got here within three, yes three, days of the appeal decision being made. I still have yet to receive my letter approving me for the quadriplegia or my back pay or any other benefit. When I questioned the VA about this they had no real answer other than, “it just takes time!” UHHH WELL… sure, but if I can receive the denial paper in 3 days why not the M’F'n approval letter? Something is rotten in Denmark folks, and it’s not the poor soldiers that have to deal with the system. It’s Jim Nicholson and his cronies. V5
I hate the VA. I get my 20%, but it took years and a fight. And none of that was combat related, so I don't even have the level of a anger to deal with. Bottom line is this as far as I am concerned: The VA is the court of last resort for people who need medical care. You get what you pay for, and I'm not trying to be funny, nor forgetting what was actually paid by those who need it, but to be frank, anyone who thinks the VA is a place where they are going to get first class care in a timely manner is just confused. And for all that, the VA is a 1000% better than when I first ETS'd. Problem is that there is no market force making the system function. And it's not the people (mostly). Vounteers and decent caring people have been the rule, but they are overworked, understaffed, and the paperwork is just too much to deal with. And as far as I'm concerned, it's where you go when you can't afford good medical care. Sound awful? Well consider this: I have a problem with one eye, service connected. I was having a problem with that eye, was going to go to lens crafters to get glasses (figured it'd be an hour). A buddy suggested the Pensacola VA, which was pretty good to work with actually, but --VERY long story short, it took me six month of several doctors appointments before I could see an eye doctor who said " you just need reading glasses... we can give you some computerglasses but you'd do better going to wal-mart for common ones!! Six!!! MONTHS! So ok, I got the PC glasses, but they were cut wrong, so I threw them away and finally got reading glasses at WalMart, where I still get my glasses. And the VA, for all of that, they made me change my bloodpressure med from what my private doctor had been prescribing (because they wouldn't see me just for my eye, they had to see the whole me), and that screwed me up in a big way, and the straw was when they insisted I needed to make an appointment for the Blood Pressure Clinic (took an hour to drive there, an hour wait, and an hour back, so half a day sick-leave), only to find out the clinic was a blood pressure test and some aggravating nurse telling me I needed to calm down so my blood pressure would register lower... It just kept going up, can't imagine why... I walked out that day and never looked back. So now, I make a doctor's appointment, I wait 10-15 minutes at MOST, I spend quality time with my physician and I don't have to explain the problem EVERY time I go there, and I get advice, or a shot, or a prescription, and I pay 20.00 and I walk out with an appointment in hand for the next time, made to suit ME, not the stupid system.... VA? Screw the VA. The government ought to contract out medical care for all vets, and make it an HMO like deal, and get government employees out of the equation. Then people will get quality care in a timely way, without all the nonsense, because people can and do vote with their feet when they have a choice. I don't know how Tricare works, but I would never go back to government provided medical care unless I was just plain indigent--and unable to get medicaid. And I can only imagine what kind of care the Canadians get if it's all socialized (read government provided)... Ugh. Funny thing is, I figured the combat vets were getting all the good care which was ok 'cause I didn't figure I had the 'right' to keep one of them from getting care. So much for that theory, eh. V/R