GAO report offers a window into the lives of wounded warriors

Correction: An earlier version of this column incorrectly said that a report on wounded Marines at Camp Lejeune, N.C., was done by the Government Accountability Office. It was issued by the Defense Department inspector general. This version has been corrected.

Walter Pincus
Reporter April 5, 2012

The dark effects of 10 years of warfare on injured fighters — drugs, anger, fear, frustration — are on display in a report on the Marine Wounded Warrior Battalion at Camp Lejeune, N.C., released by the Defense Department inspector general.

The document, released last Friday, is a reminder of how far away the suffering of these men and women and their families is from the consciousness of most Americans.

As the report notes, however, some Americans are even willing to take advantage of those who have sacrificed and suffered in the name of defending the homeland. The culprits range from illegal-drug dealers to some so-called charitable groups that, as the report politely put it, “sometimes do not have the best interests of Warriors at heart.” The report mentioned that a few unnamed agencies “had expressed disappointment that TBI [traumatic brain injury] patients did not ‘look the part.’ ”

Many times, “visiting non-military organizations wanted to see a ‘poster child’ of a wounded Marine and they would offer donations for the selected personnel and not the unit as a whole,” the battalion chaplain told the inspector general.

Some organizations would call in “looking for ‘visibly wounded’ Marines (burn victims, amputees) to participate in their events.” Some Marines complained to the inspector general about “the ‘petting zoo’ environment created when certain non-profit agencies came to visit.”

The worst offenders simply had to be kept out of the barracks, according to the report. The Lejeune unit had to institute a screening process to guard against the exploitation of wounded Marines.

The Marine Wounded Warrior program began in April 2007, after the neglect scandal at what was then the Walter Reed Army Medical Center. The program was meant to coordinate medical and non-medical care for ailing and injured Marines, combat-wounded or not, and their families. The goal was to help get the service personnel back to active duty or help them make the transition to civilian life.

With a regimental headquarters set up at Quantico, two Marine
Wounded Warrior Battalions were established, one at Camp Lejeune in North Carolina and the other at Camp Pendleton in California. Overall, the program has aided some 27,377 Marines.

At the time of the inspector general’s visit in September 2010, there were 194 Marines in the Camp Lejeune Wounded Warrior Battalion, many suffering from post-traumatic stress disorder (PTSD), TBI or spinal cord injuries. Of the group, 130 were wounded in the theater of operations. Serious problems, such as TBI and PTSD, were handled at the Naval Hospital Camp Lejeune and through the Tricare network locally.

A support team was established for each wounded Marine. The team included a noncommissioned officer as a section leader, a civilian medical case manager, a military or civilian primary-care manager, and a civilian recovery care coordinator who acted as the primary point of contact.

Overall, the inspector general found that the management and staff at the battalion and Naval Hospital at Camp Lejeune “were fully dedicated to providing the best available care and services.”

But they faced “significant challenges.”

Misuse or abuse of prescription medications, sedatives, painkillers and illegal drugs was a big problem. Most of the battalion’s Marines “were on serious medications” and many were “predisposed” to addictions, according to the battalion’s senior officer. There was no real control of medication distributed by military and civilian providers, so combating drug abuse became a top priority. That included establishing regular and surprise drug screenings.

There was a sense that the rules on drug abuse were more lenient for combat-wounded Marines and Purple Heart recipients than for others, which set a “bad tone” within the barracks. One Warrior told the inspector general that he thought nothing was done to those caught with drugs “because no one wanted to be the guy that kicked out a Marine for drugs.”

To mitigate the problem, video cameras were installed in the barracks to deter thefts of prescription medication and illegal drugs. More recently, a new policy has established “proper medication accountability of each Marine,” according to a December 2011 letter to the inspector general from the battalion commander.

Keeping people busy between medical appointments was difficult. Making various programs mandatory — internships, reconditioning programs and other structured activities — left some Warriors feeling “they were being ‘messed with,’ which created some anxiety,” according to one person interviewed by the inspector general.

Another issue for the wounded Marines was the amount of time spent waiting for decisions about their futures. The disability evaluation system involves a medical evaluation board, a physical evaluation board, disability determinations, an appeals process and a final disposition. The process can take as long as two years. Just the medical evaluation process for a wounded Marine at Lejeune was taking 245 days, the inspector general said. On a broader basis, it found that for 22 percent of Wounded Warrior Marines, final decisions still were not final three years after their original injury.

Of 696 Marines who passed through the Camp Lejeune battalion between April 2007 and September 2010, only 36 returned to active duty. Another 324 were discharged to civilian life; six died; three were forced out of the service; eight reservists returned to their units, and two reservists were discharged.

Believe it or not, 317 were still in transition.

Those numbers give life to a quote from one Warrior: “Everyone seems so depressed, angry and stressed, and they just want to get out of here.”

Remember: This is just a small part of what has happened to the 1 million service personnel sent to war over the past decade.

For previous Fine Print columns, go to washingtonpost.com/fedpage

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