Disability ratings improving, critics say - Getting out, military health issues - Navy Times

Disability ratings improving, critics say

A year after Walter Reed Army Medical Center emerged as a symbol of what is wrong with the administrative end of the military medical retirement system, much has changed for the better, critics say.

“God bless the mold on the wall, because it exposed the disability evaluation system,” said retired Army Lt. Col. Mike Parker, referring to maintenance issues at Walter Reed’s Building 18, where outpatient troops were formerly housed — issues that proved to be the tip of the iceberg of far deeper problems.

“I’m seeing better and better [disability] ratings come out — ratings I would never have seen two years ago,” said Parker, arguably the disability system’s strongest critic, who has helped many troops navigate the process and pushed hard for changes.

Percentage ratings are assigned to an injury that determine how much — if any — compensation is paid to a service member for the loss of a military career. The percentages also determine if the member will receive military health care benefits.

Parker agreed with the military surgeons general, lawmakers and an independent review group that things have improved greatly over the past year. All also agree that much still needs to be done.

“We know that there are obstacles and bureaucracies that still must be overcome,” Army Surgeon General Lt. Gen. Eric Schoomaker told the House Oversight and Government Reform national security panel Feb. 27. “We continue to face challenges that require blunt honesty, continuous self-assessment, humility and the ability to listen to those in need.”

Parker first brought the problems to Military Times in June 2006, noting that injured troops across the services were receiving different disability retirement ratings for the same injuries or being told that their injuries didn’t qualify for medical retirement because they were pre-existing conditions, even if there was no way to prove that — all while being stuck in a system that could take months, even years, to navigate. A Military Times investigation, and a second story in February 2007, showed the problems were systemic.

Even as Parker saw improvements over the past year in the system he had railed against for so long, he didn’t retreat to the sidelines.

He has spent the past year writing to lawmakers to explain the disability retirement process, demanding — and being allowed — to speak to flag officers when he sees rules broken, and serving as an adviser to disabled troops processing out of the military.

He was particularly excited about new Pentagon guidance issued in recent weeks that orders the services to abide by Department of Veterans Affairs rules for rating disabilities — and bars the services from adding extra rules of their own.

The guidance came from a new law aimed at ensuring consistent ratings across the services. For example, the ratings schedule states that service members who can’t move an injured arm too far because it hurts should be rated for range of motion to that point. The old Army policy required physical evidence — and pain didn’t qualify. That is now gone.

“It is clear that several areas regarding the rating of disability cases have been changed and that it is imperative we begin to implement these changes as soon as possible to ensure our soldiers receive the proper ratings under the new amendments,” wrote Brig. Gen. Reuben Jones, commander of the Army Physical Disability Agency.

Horace Carson, senior medical adviser for the Air Force Review Boards Agency, said the Air Force has decided to take another look at any disabled airmen whose injuries were rated at less than 30 percent — the level required for medically retired service members to qualify for lifetime benefits, instead of just a lump-sum severance payment — and may have been incorrectly rated according to old Air Force policy, rather than the ratings schedule.

The new guidance seems to be taking a little time to make its way down the chain, however. In one case that Parker is working on, a soldier asked that his range-of-motion case be reviewed again based on the new rules. His physical evaluation board in Texas said that was not necessary and awarded him a 10 percent rating — even after being provided a copy of Jones’ memo.

However, on Feb. 26, the Physical Disability Agency — the next-highest board — awarded the soldier a 40 percent rating for his back injury. The difference means retirement pay and medical benefits for the rest of his life, versus a one-time payment of a few thousand dollars and no medical benefits.

Parker praised that decision, but said, “The question remains, what will it take to get the Texas [Physical Evaluation Board] in line? If they did this to a soldier who didn’t know better and didn’t appeal, the Physical Disability Agency would likely never review the case.”

Another law enacted a year ago requires boards to explain their reasons for ratings decisions. So far, none have done so on the cases Parker has worked on, even though he requests explanations in the first paragraph of each claim he prepares.

He still worries about National Guard and reserve troops who say they were injured while on active duty, returned home and were administratively separated without ever entering the disability retirement system.

“I’m getting more e-mails from people saying they didn’t go through the system,” he said.

In one case, a guardsman had heat stroke that caused organ damage, but when he went home, he was not processed as “injured on active duty.”

“The [disability retirement] guys will never know it’s an issue because they never get into the system,” Parker said. “There are procedures that are established, but no one’s following them.”

Still, Parker is hopeful that the positive changes will continue — as is Jones, who told his troops to expect more changes that will provide a “better and more consistent transition.”

The Air Force’s Carson said all the services are reviewing their policies to adjust to the new Pentagon guidance.

As for Parker, he said he is now shifting away from representing cases and toward offering advice and guidance.

But he said he had to get down on the ground level and work a certain amount of cases to gather the “ammunition” he needed to help change the law.

“If all I did was fix a few cases, the problems would never end.”

DISCUSS: What more needs to change?