CELEBRITY IN CHIEF BARRY O COMPLETED ANOTHER HARD DAY OF WORK AND, LIKE MOST OF HIS HARD WORKING DAYS, IT WAS ALL ABOUT FUNDRAISING FOR HIS OWN INTERESTS.
MEANWHILE HE'S FACING CRITICISM FOR HIS DOUBLE STANDARDS, FOR BEING THE REAL PRIVATE EQUITY KING, FOR BEING A TOOL AND TOY OF DESTRUCTIVE CORPORATIONS, AND FOR THE TIRED JOKES ABOUT HIS EARS FROM A PRESUMED CLOSETED GAY ACTOR.
SNIFFED BARRY O THIS MORNING, "HE'S JUST JEALOUS ABOUT MY RELATIONSHIP WITH THE CLOON-STER."
FROM THE TCI WIRE:
Chair Patty Murray: Almost a
year ago today, this Committee held a hearing on VA and DoD efforts to
improve transition. We explored a number of issues including the
Integrated Disability Evaluation System. At the hearing, we had an
opportunity to hear from both departments about the state of the joint
program. The Departments' testimony that day spoke to how the
Departments had created a more transparent and consistent and
expeditious disability evaluation process. There testimony also states
that IDES is a fair, faster process. Well now that the joint system has
been implemented nationwide, I have to say that I am far from convinced
the Departments have implemented a disability evaluation process that is
truly transparent, consistent or expeditious. There are now over
27,000 service members involved in the disability evaluation system. As
more and more men and women return from Afghanistan and as the
military downsizes, we're going to continue to see an even larger group
of service members transition from the military through the disability
evaluation process. This process impacts every aspect of a service
member's life while they transition out of the military. But it doesn't
stop there. If the system doesn't work right, it can also negatively
affect a service member and their family well after they have left
active duty.
This
morning the Senate Veterans Affairs Committee held a hearing entitled
"Seamless Transition: Review of the Integrated Disability Evaluation
System." Senator Patty Murray is the Chair of the Committee, Senator
Richard Burr is the Ranking Member. There was one panel of witnesses:
DoD's Dr. Jo Ann Rooney, GAO's Daniel Bertoni and the VA's John
Gingrich. The hearing was prompted by, among other things, the Interim
Committee Staff Report: Investigation of Joint Disability Evaluation
System
Research for the report resulted in
many discoveries including basic errors not being caught such as, "A
servicemember with a lung condition who was being treated with steroids
and immunosuppressive drugs was incorrectly rated at 0% rather than
100%." The report found many problems regarding the VA recognizing TBI
(Traumatic Brain Injury):
Some
VA medical examinations involving TBI failed to address findings on
detailed neuropsychological testing conducted during service. TBI
facets such as memory are reported as "normal" based on "general
conversation" without repeating or referencing prior tests, which
identified the type and severity of the servicemember's TBI deficits.
In a number of cases, TBI and PTSD conditions were rated together when
the evidence suggested that some of the TBI conditions should have been
considered separately. For example:
• Testing
that would help to differentiate between TBI and mental health
conditions was not conducted despite indications of deficits, such as
visual-spatial orientation and memory loss due to organic injuries (such
as trauma to a specific part of the brain associated with certain
deficits).
• VA claims for TBI residuals
were denied or received a lower rating based on the absence of objective
testing. If testing had been conducted, objective evidence of TBI for
symptoms complained of by the servicemember, might have changed the
result.
• Conclusions by VA examiners were
inconsistent with the medical evidence, such as an examination for TBI
which found no TBI to support a diagnosis of post-traumatic headaches,
but indicated that the same veteran's dizziness following an IED blast
injury was due to his TBI.
• A
servicemember diagnosed with anxiety disorder prior to separation was
erroneously denied service-connection for PTSD when the disability had
been diagnosed as anxiety disorder due to combat.
Chair
Murray noted the case of Sgt 1st Class Stephen Davis who is a veteran
of both the Iraq War and the Afghanistan War and was receiving treatment
for Post Traumatic Stress for about a year before he was accused of
"making up his ailments" and he was part of a group at Joint Base
Lewis-McChord: "All of these men and women had been diagnosed with, and
in many cases were receiving treatment for, PTSD during service. But
then, during the disability evaluation process they were told that they
were exaggerating their symptoms, they were labeled as malingerers and
their behavioral health diagnoses were changed. " She noted that a
re-evaluation process of examining 196 service members who were
diagnosed with PTSD and then told they did not have it. The
re-evaluation process has already found that, yes, 108 of those service
members do have PTSD (as originally diagnosed).
Chair
Patty Murray: Dr. Rooney, let me start with you. We have had in the
past regarding this joint disability rating system and the number of
challenges service members faced while they were going through this
process. Recently, it has come to my attention that some of our service
members involved with the disability evaluation process are facing
retribution and unsupportive behavior from their chains of command while
on limited duty and waiting for a disability decision. I've heard from
service members who were forced to participate in activities in direct
violation of doctors' orders, who've been disciplined while struggling
with behavioral health conditions and who have struggled to get access
to care because their leadership would not cooperate with their
treatment requirements. I think you agree with me, that is completely
unacceptable. Whether in a warrior transition unit or not, leaders have
to understand these medical issues and the difficult process that
these service members are going through and they have to provide the
leadership and support that these men and women need. So I'm going to
begin with you by asking you, Dr. Rooney, what needs to be done to
provide supportive and compassionate leadership for these injured
service members that are forced to wait for a disability decision.
Dr.
Jo Ann Rooney: Clearly the information you just shared is troubling on
many levels and I would be very interested in speaking with you or your
staff so that we can actually determine where those issues are occurring
and make sure that, in fact, the leadership does know -- which is the
department's decision and the leadership that I'm familiar with -- that
that cannot be tolerated, that we must understand what is necessary for
the care, that there are no stigmas with being able to address
behavioral health or mental health issues and that really is the
department's position. So in those cases, if there are those
substantive issues that you mentioned, not only do we need to find out
where those are so we can work directly with that leadership and correct
that situation, but we will continue with our ongoing work at all
levels of command -- not just at the senior level of the department.
But we understand that it needs to go right through the command level
of every installation to ensure, in fact, that the situations you
described are not occurring.
Chair
Patty Murray: Well we need to make sure that's happening because, as we
all know, these are very challenging situations for these soldiers and
any kind of retribution shouldn't be tolerated whether it's one case or
many. But I will share those with you but I want to make sure that
system wide, that leaders throughout the chain of command all the way to
the bottom are clearly understanding what these soldiers are going
through and are not having any kind of repercussions on those
individuals.
Dr. Jo Ann Rooney: Absolutely.
Chair
Patty Murray: Mr. Gingrich, from the perspective of someone who has
served in many leadership positions within the military, what can we do
to educate our military leaders on not only this process but really on
the medical issues facing so many of these young men and women?
John
Gingrich: Madam Chairman, I see a lot of things that the Army's doing
and I know that because I've been in their VCTs. They started, as we're
told by GAO, they're now bringing in in layers all the way up to the
Vice Chief of Staff so they've involved current level discussion groups
-- Brigadier General, Major General, all the way up and they included VA
in every one of those discussion groups. So I think getting the
information is the biggest key that we've got and the biggest challenge
that we have. The Secretary right now, yesterday, spoke to the Sergeant
Major Academy in the Army and the Sergeant Majors are now understanding
that this is a problem that we have to take on as two departments and
not just one. And I think that education is happening.
Chair Patty Murray: Well we still have a lot of work to do --
John Gingrich: Yes, sir -- Yes, ma'am, we do.
Chair
Patty Murray: Okay. Dr. Rooney, there is no doubt that the events at
Madigan have shaken the trust and confidence of service members who are
in the Disability Evaluation System. I believe that transparency and
sharing information about the ongoing re-evaluations that are happening
today and actions the Army and DoD are taking to remedy this situation
will go along ways towards restoring some trust in this system. I wanted
to ask you today what we have learned from the investigations that the
army is conducting into the forensic science unit at Madigan?
Dr.
Jo Ann Rooney: Well as you pointed out earlier, there have been 196
re-evaluations completed to date. Of which, 108 of those have been
diagnosed as having PTSD where before they had not. We also --
Chair
Patty Murray: Let me just say that they had been diagnosed with PTSD.
When they went through the evaluation system they were told they did
not. Now going back and re-evaluating them once they've gone out, we're
saying, "Yes, you did --
Dr. Jo Ann Rooney: Yes.
Chair Patty Murray: -- indeed have PTSD."
Dr. Jo Ann Rooney: Correct. 108 of those 196.
Chair Patty Murray: More than half.
Dr.
Jo Ann Rooney: Correct. There are 419 that have been determined to be
eligible for re-evaluation. 287 from the original group that was
looked at and as you know the Army actually opened the aperture up to
see anybody else who would have gone through the process while forensic
psychiatrists were being used. So that was 419 totally eligible for
re-evaluation. And at this point, there are three in progress and twelve
being scheduled. So what we have learned from that is clearly that the
process that was put into place at that time did not function as
originally designed. Evidence did not show that there was a mean
spirited attempt but really to create similar diagnoses. Obviously,
that was not something that occurred. So the Army has taken the lessons
from here and it's actually going back to 2001 to re-evaluate all of
the cases where we might have a similar situation. What we're doing
from that point is not only learning from what Army is doing and looking
at these re-evaluations where we're using the new standards in many
ways advances in the medical and behavioral health areas to better
diagnose PTSD but also then we'll be taking those lessons learned across
the other services as well. So since Army has the greatest majority of
people going through -- currently about 68% of the people in the
Disability Evaluation Process are from Army -- we will take the lessons
learned from there and apply those across to all the services.
Chair
Patty Murray: Well I really appreciate the Army's announcement that
they are now going to do a comprehensive review of PTSD and behavioral
health systemwide throughout the Army. I believe that is a first and
important major step for the Army to be doing. But I did want to ask
you, Dr. Rooney, I have been told by Secretary [of the Army] McHugh
about the issues we were seeing at Madigan were not systemwide. And
then the Secretary announced a comprehensive review across all systems.
So if we didn't believe this was a system wide problem, what led the
Army to look into a system wide review?
Dr.
Jo Ann Rooney: Secretary McHugh and I have had numerous conversations
and I believe the use of the forensic psychiatrists was primarily
isolated to Madigan and that's where I believe that comment of it wasn't
system wide because that type of additional process --
Chair
Patty Murray: So the forensic system wasn't system wide. But system
wide, we have issues with people who are not being diagnosed correctly?
Dr.
Jo Ann Rooney: What we want to do is look across the system and ensure
that if we do have issues we identify those and we're able to get those
individuals back into the system. So I believe at this point, it was
very much a forward leaning approach to say we need to look across the
system, not that we're convinced similar problems existed, but that it's
the right thing to do for the individuals since, as you pointed out, we
saw a number of these re-evaluations ended up with diagnoses changed.
So it's the right thing to do for people to look across.
Chair
Patty Murray: Okay and I think it's extremely important that we find
anybody who was misdiagnosed and get them care. So we'll be continuing
to focus on this.
Later during
Senator Jon Tester's questioning, Dr. Jo Ann Rooney would insist to him
that most of the changed diagnoses "were before 2008" and Chair Murray
would have to step and offer, "Let me just clarify a large number of the
ones who were misdiagnosed or had their diagnoses changed inaccurately
were after the 2008 -- after the forensic psychology system was put in
place."
Ava will cover Tester at Trina's site tonight, as always Kat will grab Ranking Member Richard Burr as the topic for her site and Wally will offer some thoughts on the financial at Rebecca's site.
Still on the subject of the US Senate, we'll note this from Senator Ron Wyden's office:
Wednesday, May 23, 2012
Washington, D.C.
– In a letter to Secretary of Defense Leon Panetta, U.S. Senator Ron
Wyden (D-Ore.) called on the DoD to investigate the excessive expenses
racked up by the legal team of Kellogg, Brown and Root (KBR) – a defense
contractor that operated in Iraq with the contractual ability to pass
all of their legal costs to American taxpayers. A lawsuit against KBR
brought by a group of Oregon National Guard members assigned to provide
security for KBR personnel claims that KBR management knew that the
soldiers were being exposed to toxic chemicals while working at the
Qarmat Ali water treatment plant.
A newly
declassified indemnification provision in the KBR contract with the U.S.
military releases the contractors from all financial liability for
misconduct and allows KBR to pass the on all of their legal costs to the
U.S. government. Recent investigations into the conduct of KBR's legal
team have uncovered excessive legal costs including senior attorneys
billing at $750 per hour, taking numerous international and domestic
first class flights and paying one expert more than $500,000 for
testimony and consultation who has admitted to billing KBR for time
spent sleeping.
"Essentially, KBR was
handed a blank check with the Pentagon's signature, and it seems clear
to me that they intend to run up the bill as much as possible before
cashing that check," Wyden wrote in the letter. "What has DoD done to
ensure that KBR is not taking advantage of taxpayers? Has DoD done a
detailed audit of KBR's legal expenses so far? Has anyone at DoD
checked to see if the legal expenses are excessive? Has any kind of
cost-benefit been done to determine if it would be cheaper to direct KBR
to settle the lawsuit?"
Kellogg, Brown and
Root were contracted in 2003 to perform clean-up work at the Qarmat Ali
water treatment facility in Iraq. Members of the Oregon National Guard
were assigned to provide security for the KBR contractors and were
exposed to dangerous levels of toxic chemicals including sodium
dichromate, a carcinogen that contains hexavalent chromium – one of the
most dangerous chemicals on Earth. A group of exposed soldiers have
brought a lawsuit against KBR based on evidence indicating that KBR
managers "were aware of the presence of dangerous chemicals, but failed
to warn the soldiers working in and around the plant," Wyden wrote in
the letter.
Under KBR's contract, the
government has the ability to direct KBR's legal defense and require the
company to settle with Oregon Guard Members.
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