Congressional Hearing on Walter Reed Army Medical Center

House Committee on Oversight and Government Reform, Subcommittee on National Security and Foreign Affairs

SPEAKERS:

REP. JOHN F. TIERNEY, D-MASS. CHAIRMAN

REP. CAROLYN B. MALONEY, D-N.Y.

REP. STEPHEN F. LYNCH, D-MASS.

REP. BRIAN HIGGINS, D-N.Y.

REP. JOHN YARMUTH, D-KY.

REP. BRUCE BRALEY, D-IOWA

REP. BETTY MCCOLLUM, D-MINN.

REP. JIM COOPER, D-TENN.

REP. CHRIS VAN HOLLEN, D-MD.

REP. PAUL W. HODES, D-N.H.

REP. PETER WELCH, D-VT.

REP. TOM LANTOS, D-CALIF.

REP. HENRY A. WAXMAN, D-CALIF. EX OFFICIO

REP. CHRISTOPHER SHAYS, R-CONN. RANKING MEMBER

REP. DAN BURTON, R-IND.

REP. JOHN M. MCHUGH, R-N.Y.

REP. TODD R. PLATTS, R-PA.

REP. JOHN J. "JIMMY" DUNCAN JR., R-TENN.

REP. MICHAEL R. TURNER, R-OHIO

REP. KENNY MARCHANT, R-TEXAS

REP. LYNN WESTMORELAND, R-GA.

REP. PATRICK T. MCHENRY, R-N.C.

REP. VIRGINIA FOXX, R-N.C.

REP. THOMAS M. DAVIS III, R-VA. EX OFFICIO

REP. ELIJAH E. CUMMINGS, D-MD.

DEL. ELEANOR HOLMES NORTON, D-D.C.

WITNESSES:

DR. PETER GUERIN,

UNDERSECRETARY OF THE ARMY

STAFF SERGEANT JOHN DANIEL SHANNON (USA)

SPECIALIST JEREMY DUNCAN (USA)

ANNETTE MCLEOD,

WIFE OF SPECIALIST WENDELL "DELL" MCLEOD (USA)

LIEUTENANT GENERAL KEVIN C. KILEY, M.D. (USA),

U.S. ARMY SURGEON GENERAL

MAJOR GENERAL GEORGE W. WEIGHTMAN (USA),

FORMER COMMANDER,

WALTER REED ARMY MEDICAL CENTER

CYNTHIA A. BASCETTA,

DIRECTOR OF HEALTH CARE,

GOVERNMENT ACCOUNTABILITY OFFICE

GENERAL PETER SCHOOMAKER (USA),

ARMY CHIEF OF STAFF

GENERAL RICHARD CODY (USA),

ARMY VICE CHIEF OF STAFF

[*]

TIERNEY: A quorum being present, the Subcommittee on National Security and Foreign Affairs entitled: "Is This Any Way to Treat Our Troops: The Care and Condition of Wounded Soldiers at Walter Reed" will come to order.

I ask unanimous consent that the chairman and ranking minority member of the subcommittee, as well as the ranking minority member of the committee, be allowed to have five minutes to make opening statements.

Without objection, that is ordered.

And I would also like to first introduce the undersecretary, Peter Guerin, who would like to welcome people here in a brief statement.

Mr. Guerin?

GUERIN: Thank you, Mr. Chairman, members of the committee.

I'm the undersecretary of the Army now. Next Friday, I'll be the acting secretary of the Army. Last Friday night, the secretary asked me to take on the health care issue for the Army in the meantime, not wait until I become acting secretary next Friday.

On behalf of the Army, I want to welcome all of you to Walter Reed. As a former member of Congress, I want you to know I appreciate and value the role this Congress and this committee plays in the life of our Army. We treasure the partnership we have with Congress. We understand that the Constitution has forged the partnership from the beginning of this country for as long as this country lasts between Congress and our United States Army.

We have let some soldiers down. And working with the Congress and the leadership of the Army, all the way down to the lowest ranking civilian or uniformed military, we're going to fix that problem. In fact, we're in the process of fixing it.

Your involvement is going to help us do that. I'm glad so many of you are here today, showing this kind of interest in Walter Reed.

So many of you have been out here many, many times, been a part of the life at Walter Reed, worked with members and staff over the last several years in dealing with related problems. And we appreciate very much the role that the Congress plays.

There's a vow that's part of the soldier's creed: "I will never leave a fallen comrade."

GUERIN: That's the -- on the battlefield, in a hospital, as an outpatient.

(CROSSTALK)

GUERIN: That is the part of our soul of every soldier. And anytime that vow is broken, I can tell you it hurts the heart of the Army.

The men and women of Walter Reed are dedicated professionals. They make a considerable sacrifice, both financial and personal, to meet the needs of the patients here at Walter Reed, to meet the needs of the families. They provide excellent health care.

When it comes to wounded warriors, they set the standard for the world in health care. And they do this and turn down offers in private industry to make several times more money. They do it because they believe in the soldier's creed. They are dedicated to their fallen comrades, and it hurts them deeply when they see any members of this service (inaudible).

On behalf of the staff here, I also offer this welcome. They look forward to working with you. I want to thank them for their work. And again, Mr. Chairman, thank you, Chairman Waxman, Ranking Member (inaudible). I appreciate you being here.

TIERNEY: Thank you, Mr. Guerin.

A little bit of house cleaning here first.

I ask unanimous consent that the hearing record be kept open for five business days, so that all members of the subcommittee may be allowed to submit a written statement for the record.

Without objection, that's ordered.

I also ask that the following written statements be made part of the hearing record: the Iraq and Afghanistan veterans of America; Joe Wilson, social worker, Psychiatric Continuity Service; Sergeant David Yansey (ph), Mississippi National Guard; Sergeant Archie (ph) and Barbara Benware (ph); John Allen (ph), former sergeant first class, North Carolina National Guard; and Marine Sergeant Ryan Groves of Ohio.

Without objection, so ordered.

I also ask unanimous consent of the gentleman from Maryland, Representative Elijah Cummings, and the delegate from the District of Columbia, Representative Eleanor Holmes Norton, members of the full Committee on Oversight and Government Reform be permitted to participate in the hearing.

In accordance with our committee practices, they'll be recognized after all members of the subcommittee.

Without objection, so ordered.

TIERNEY: So, getting down to business, let me, first and foremost, welcome everybody here and thank the brave soldiers at Walter Reed for allowing us to have this hearing at this facility.

Thank you all for your service and your patriotism and your courage. Everybody here is mindful of what you've done and how you've answered the call of this country, without distinction for party or any other factor.

You're an inspiration to all of us. And from the bottom of our hearts, we appreciate all that you've done for your country and for each of us.

I also want to welcome the members of the National Security and Foreign Affairs Subcommittee.

It was vital that we convene a hearing at Walter Reed so that we'd be able to see and hear for ourselves whether or not what we've seen reported is actually accurate and true.

I intend that this subcommittee will conduct hearings and investigations into many areas of defense and homeland security and foreign policy. I can think of no more important topic for our very first hearing than the proper care of our nation's wounded soldiers.

I'd like to start by playing a short video clip from the WashingtonPost.com Web site that, I think, indicates for us the seriousness of this matter.

(BEGIN VIDEO CLIP)

(UNKNOWN): Marine Sergeant Ryan Groves told us he thought that the wounded at Walter Reed were treated more like front-line troops than outpatients. His mom came to be with him and he got hell for it. So he fought back and she stayed.

Staff Sergeant Dan Shannon loves the U.S. Army. But he couldn't understand why they didn't keep better track of soldiers, so he designed his own system for keeping track of them.

Sergeant Shannon has a wife and three kids, but he also has a bad case of PTSD, so the doctor gave him a separate room because his son's loud toys set him off.

Eventually, the Army made the entire family live in one small room. Shannon was motivated to help out when this corporal, Jeremy Harper, who was only 19 years old when he died of alcohol poisoning -- he was found in his room New Year's Day, 2005.

(UNKNOWN): Lots of soldiers told us they got the wrong medical records. Archie Benware, in the National Guard, got the gynecological report from a female soldier sent to him.

Building 18 was built in the mid-'30s. Now they're housing soldiers there. They talk about it as a depressing, isolating place.

Specialist Jeremy Duncan was rather surprised when mold started invading his room and he couldn't get anybody to fix it. Duncan almost died in Iraq. He's been in Walter Reed for more than a year. He's very grateful for the medical treatment he's received. He's about to get a new ear.

(END VIDEO CLIP)

TIERNEY: So Walter Reed has long been perceived as the model for taking care of our nation's soldiers when they return from battle.

The secretary is absolutely correct that people respect and honor the service of the medical personnel and other staff that are here at the hospital. But when we look at the unsanitary conditions and some of the other situations in the living quarters, we find it appalling.

But we also realize that not only is it flat wrong, that's the tip of the iceberg. For too many occasions, the soldiers at Walter Reed wait months, if not years, in sort of a limbo. And they must navigate through broken administrative processes and layers upon layers of bureaucracy to get their basic tasks accomplished.

Today, we're going to hear firsthand of the conditions and the lack of respect for our soldiers and their families.

I want to thank Staff Sergeant Dan Shannon; Corporal Dell McLeod and his wife, Annette; and Specialist Jeremy Duncan for your bravery, for your service, for your sacrifice, and for sharing your experiences with us here on this panel today.

I understand that you're frustrated. I think we all understand that. And we respect the fact and we understand why you are.

But let me be clear: This is absolutely the wrong way to treat our troops, and serious reforms need to happen immediately.

Over the past month, the perception of Walter Reed has gone from the flagship of our military health system to a glaring problem. This subcommittee wants some answers.

I want to thank Major General Weightman, former commander of Walter Reed; Lieutenant General Kiley, and the Army's current surgeon general, and also a former commander at Walter Reed. I want to thank General Cody, the vice chief of staff of the Army, and the Army's point person on this issue, for being with us today, as will be General Schoomaker.

I look forward to hearing from all of you why our wounded soldiers have been not getting the care and the living conditions that they deserve. I also want to hear what we're going to do about it in the future.

I want to stress that this is an investigative hearing and not an inquisition. Our purpose is to get to the bottom of things and to get honest answers. And it will take our cooperative efforts, all of us working together, to make sure that a broken system is fixed and fixed quickly.

That all being said, I do have serious concerns and many, many questions.

TIERNEY: First, is this just another horrific consequence of the terrible planning that went into our invasion of Iraq?

Did the fact that our top civilian leaders predicted a short war, where we would be greeted as liberators, lead to a lack of planning, in terms of adequate resources and facilities devoted to the care of our wounded soldiers?

Are we headed down the same path again with the president's surge, or are we prepared this time for the increase of injuries, patients and wounded veterans?

What concrete steps have been taken and are being taken, as a reaction to the surge, to make sure that every soldier gets cared for properly?

Did an ideological push for privatization put the care of our wounded heroes at risk?

A September 2006 memorandum that this committee has obtained describes how the Army's decision to privatize was causing an exodus of, and I quote, "highly skilled and experienced personnel from Walter Reed" and that there was a fear that patient care services are at risk of mission failure.

Did the fact that Walter Reed is scheduled to close in 2011 because of BRAC, Base Realignment and Closure, process, contribute to unacceptable conditions at Building 18 and elsewhere?

And with a Defense Department budget of $450 billion and more, this is not a case of there not being enough money to take care of our wounded soldiers. This is a case of a lack of proper prioritization and focus.

More and more evidence is appearing to indicate that senior officials were aware for several years of the types of problems that were recently expressed in the excellent reporting by The Washington Post reporters.

These are not new or sudden problems. Rats and cockroaches don't burrow and infest overnight. Mold and holes in ceilings don't occur in a week. And complaints of bureaucratic indifference have been reported for years.

Moreover, this committee, under former Chairman Davis and Chairman Shays, have been investigating, over the past several years, problems faced by our wounded soldiers, including those at Walter Reed. And I want to thank those members for their leadership so far.

TIERNEY: I also want to thank Congressman Peter Welsh of Vermont and others, who insisted that this committee have its first hearing out here at Walter Reed so we could see firsthand the conditions at question.

Where does the buck stop? There appears to be a pattern developing here that we've seen before: first deny, then try to cover up, then designate a fall guy. In this case, I have concerns that the Army is literally trying to whitewash over the problems.

I appreciate the first steps that have been taken to rectify the problems at Walter Reed and to hold those responsible accountable. We need a sustained focus here, and much more needs to be done.

I also, unfortunately, feel that these problems go well beyond the walls of Walter Reed, and that they are problems systemic throughout the military health care system. And as we send more and more troops into Iraq and Afghanistan, these problems are only going to get worse, not better. And we should be prepared to deal with them.

Let me conclude by thanking all the soldiers who were able to be with us here today for their sacrifice for their sacrifice on all of our behalf. We all agree that our soldiers deserve the best possible care, so let's give them that respect and gratitude that they rightly deserve. They have earned it with their dedication, with their patriotism, and with their sacrifice.

And with that I yield to Mr. Shays or Mr. Davis for his opening statement.

SHAYS: Thank you, Mr. Chairman.

Mr. Chairman, I'm going to defer my statement. I know we've got a short agenda, time, and we'll just have one on each side. So I welcome Mr. Davis making our statement.

DAVIS: Thank you, Mr. Shays.

And let me thank Chairman Waxman and Chairman Tierney for agreeing to convene this hearing at the Walter Reed Army Medical Center.

For too long, complaints about substandard and disjointed care for wounded soldiers who have been treated as distant abstractions. Here, no one should be distracted by numbing statistics, soul-less technical jargon, impersonal flow charts, or rosy, good-news action plans.

Here, we get an unfiltered look at a tortuous system that has proved so far stubbornly incapable of reaching the standard of care this nation is honor-bound to provide returning warriors.

We meet in the grounds of a world-class, world-renowned medical institution. Walter Reed has a venerable tradition of scientific advancement and clinical success. No one cared for here -- yesterday, today or tomorrow -- should doubt the skill and dedication of the doctors, nurses and administrative staff who labor every day to save lives and repair broken bodies and minds.

The problems that bring us here today are the product of institutional indifference, not a lack of individual commitment. Recent reports of decrepit facilities and dysfunctional outpatient procedures at Walter Reed amplified oversight work this committee started in 2004.

DAVIS: Pay and personnel systems that got it wrong far more than it got it right were inflicting financial friendly fire on those returning from war.

Some of those erroneous dunning notices found their way here. Men and women already struggling to regain their physical health were also being forced to fight their own government to protect their financial well-being. Members of the National Guard and Reserve units have a particularly difficult time navigating this Byzantine, stovepiped, paper-choked process that was never intended to deal with so many for so long.

The charts that we have lay out only parts of the MedHold system.

Apparently, some other pre-war planning errors that the Pentagon somehow failed to anticipate, deploying unprecedented numbers of reserve component troops into combat would produce an unprecedented flow of casualties.

As a result, the Defense Department has been scrambling ever since to lash together last-century procedures and systems to care for returning citizen soldiers. But institutional habits and biases have proven remarkably impervious to demands for change.

It took well over a year to stand up an ombudsman program to help guide soldiers and their families through a complex, confusing and frustrating medical and administrative labyrinth involving mountains of forms and multiple Army commands.

Last October, a systems analysis review team inspection of Walter Reed found no process to track submitted work orders, particularly for Building 18. They pronounced the facility "otherwise safe and secure." That must have been remarkably fast-growing mold that we found in The Washington Post in Building 18.

Two years ago, the Government Reform Committee heard testimony that concluded: "Army guidance for processing patients in medical hold units does not clearly define organizational responsibilities or performance standards.

"The Army has not educated soldiers about medical and personnel processing or adequately trained Army personnel responsible for helping soldiers.

"The Army lacks an integrated medical and personnel system to provide visibility over injured soldiers and as a result sometimes actually loses track of soldiers and where they are in the process."

And "The Army lacks compassionate customer friendly service."

The last one says it all and sadly appears to be as true today as in 2005.

These problems not unique to Walter Reed. Here uncertainty over the use of contractors or decisions by the Base Closure and Realignment Commission may have contributed to staff turnover and attrition.

But the crushing complexity and glacial pace of outpatient procedures in medical evaluation boards are Army-wide problems.

Building 18 is just one visible symptom of a far more insidious and pervasive malady. All the plaster and paint in the world won't cure a system that seems institutionally predisposed to treat wounded soldiers like inconveniences rather than heroes.

On the long road home from war, this is a place wounded soldiers and their families should be embraced, not abandoned. They should be healed and nurtured, not left to languish or fend for themselves against a faceless bureaucratic hydra.

DAVIS: What will transform this dysfunctional, uncaring arrangement into the compassionate, effective medical and military operation wounded soldiers deserve? All our witnesses today will help us find the answer to that question.

Those in our first panel speak from hard personal experience. They have every reason to be disillusioned, even bitter, about frustrations and indignities they endured or witnessed while captive to a broken process.

Their testimony is one more selfless act of bravery, and we are profoundly grateful for their willingness to speak out.

TIERNEY: Thank you, Mr. Davis.

The subcommittee will now receive some testimony from the witnesses before us today. I would like to start by introducing those witnesses on the first panel.

We have Staff Sergeant John Daniel "Dan" Shannon, I resident of Walter Reed since he was injured near Ramadi, Iraq, in November 2004. We have Mrs. Annette McLeod and her husband, Specialist Wendell "Dell" McLeod Jr. from Chesterfield, South Carolina. Actually, Mrs. McLeod will be testifying; Dell is with us here today. And Specialist Jeremy Duncan, currently an outpatient at Walter Reed residence who was housed in Building 18.

Welcome to all of you. Thank you for coming and sharing your experiences here today.

It's the policy of this subcommittee to swear you in before we testify, so I'm going to ask you to please stand and raise your right hand.

Do you solemnly swear to tell the truth, the whole truth and nothing but the truth?

Record will please reflect that all of the witnesses so swore.

And I'm going to ask that each of you now give a brief statement. We'll start from my left with Staff Sergeant Shannon, then Mrs. McLeod and Specialist Duncan. The statement are five minutes. If you can, please try to contain your remarks. Davis to my left is going to throw something in the air to get my attention when you get near that point in time and I'll just try to give you a signal. But we do want to allow you to fully express yourselves.

So, Staff Sergeant Shannon, if you'd please start.

SHANNON: Yes, sir. And I apologize, I do have a written statement so that I can stay within those time constraints. And of course more information with the written statement I submitted.

TIERNEY: All of the written statements have been entered in the record and will be there.

SHANNON: Mr. Chairman and members of the committee, thank you for inviting me to testify today on issues at Walter Reed Medical Center. My name is Staff Sergeant John Daniel Shannon. I do go by my middle name.

What has brought me to speak is my personal ethic as a professional soldier. I will not see young men and women who have had their lives shattered in service to their country receive anything less than dignity and respect.

I was wounded while serving in Iraq with the 1st Battalion, 503rd Infantry Regiment. We were conducting operations in out of Habbaniya, Iraq, and had moved to combat outpost, a small compound on the southeast side of Ramadi.

SHANNON: On November 13, 2004, I suffered a gunshot wound to the head from an AK-47 during a firefight with insurgent forces near Saddam's mosque. The result of that wound was primarily a traumatic brain injury and the loss of my left eye.

I arrived at the Walter Reed Army Medical Center's Ward 58 on or about the 16th of November, 2004. I was just discharged in outpatient status on approximately the 18th of November, 2004.

Upon my discharge, hospital staff gave me a photocopied map of the installation and told me to go to the Mologne House where I would live in while in outpatient. I was extremely disoriented and wandered around while looking for someone to direct me to the Mologne House. Eventually I found it.

I had been given a couple of weeks' appointments and some other paperwork upon leaving Ward 58, and I went to all my appointments during that time.

After these appointments, I sat in my room for another couple of weeks wondering when someone would contact me about my continuing medical care. Finally, I went through the paperwork I was given and started calling all the phone numbers until I reached my case manager, who promptly got me the appointments I needed.

I soon made contact with the medical holding company. At that time, I was in process and assigned to the 2nd Platoon MedHold company. I was informed that my medical evaluation board/physical evaluation board would not proceed until my face was put back together. This process is important to me because the result of the evaluation determines the percentage of my disability.

During the time my injuries were being fixed, post-traumatic stress disorder symptoms started surfacing. I was informed that the medical retirement process would not proceed until the PTSD was medicinally controlled.

Months later, I was informed that my medical board paperwork -- my medical board had to be restarted because my information had been lost. I began meeting with my new physical evaluation counselor, Mr. Geiss (ph), in late January and early February.

SHANNON: He informs that my MEB needed to be stopped again, until the plastic surgery and ocular prosthetic procedures were finished.

Therefore, two years after first being admitted to Walter Reed, I'm hearing the same thing about the process that I heard when I first began it two years ago.

I want to leave this place. I have seen so many soldiers get so frustrated with the process that they will sign anything presented to them just so they can get on with their lives.

We have almost no advocacy that is not working for the government, no one that we can talk to about this process who is knowledgeable and we can trust is going to give us fair treatment and informed guidance.

My physical evaluation counselor in the MEB/PEB process both worked for the government and have its interests, not our interests, in mind, in my opinion.

Danny Soto, who works in the Malogne House as an independent advocate for those of us going through the process, is priceless in the assistance he gives. But he is only one man.

The system can't be trusted. And soldiers get less than they deserve from a system seemingly designed and run to cut the costs associated with fighting this war.

The truly sad thing is that surviving veterans from every war we've ever fought can tell the same basic story: a story about neglect, lack of advocacy and frustration with the military bureaucracy.

Thank you again for allowing me the opportunity to share my experiences with this committee.

TIERNEY: Thank you, Staff Sergeant.

Mrs. McLeod?

MCLEOD: Mr. Chairman and members of the committee, thank you for holding this hearing today. My name is Annette McLeod and I am testifying today because my husband Wendell has been through the nightmares of the Army medical system.

I'm glad that you care about what happened to my husband after he was injured in the line of duty. Because for a long time, it seemed like I was the only one who cared.

Certainly, the Army didn't care. I didn't even find out that he was injured until he called me himself from a hospital in New Jersey.

When the Army realized it had made a mistake and sent him to Fort Dix instead of Walter Reed, they transferred him days later.

On September 23rd of 2004, Wendell was deployed on the Iraqi border in the 1178th Artillery out of (inaudible), South Carolina. He had been a soldier with the National Guard for 16 years when he was activated for this deployment.

About 10 months into his tour, he was hit in the head by a steel cargo door of an 18-wheeler while performing an inventory. The injuries were serious enough that he had to be evacuated to Germany under heavy medication. And after the hospital mix-up I just mentioned, he was sent to Summit Hills apartment complex leased at Walter Reed.

I took a leave from my job and went to see him in the capacity of a nonmedical attendant with Army approval. This was in August of 2005.

When I arrived to care for him, I found that he had no appointments scheduled with any Walter Reed staff. He had been assigned a social worker. Aside from the evaluation he received after his injury, the Army had just left him at Summit Hills, without any evaluation opportunities and therefore no treatment.

I complained and had him transferred to the Malogne House, where he clearly could get some help. He had back and shoulder injuries and mental problems.

After being admitted to the Malogne House, he was tested for brain functioning and comprehension. I remember how medicated he was when they gave him the test.

Later, the Army said the tests were inconclusive because he didn't try hard enough.

We waited for four months to get those results.

MCLEOD: He is a high school graduate. As I said before, he served in the National Guard for 16 and a half years. But the Army refuses to acknowledge that he suffered a brain injury.

He freely told the Army that he was a Title I math and English student in grade school, meaning that he needed extra help with reading and math. But the Army has taken this information and used it against him.

Over the months, we have listened in disbelief as the Army interpreted Title I math and English to mean that he has a learning disability. He was considered fit enough to serve in the National Guard for 16 years. He was fit enough for deployment. But now they're saying his mental problems he had before he went to Iraq.

In January of 2006, he was sent to a neurological care facility in Virginia for 10 weeks, at my urging. Before he transferred, he received steroid shots in his back for his back injury. I was assured by the Army that this was the first of many treatments. But for 10 weeks while he was in Virginia, he didn't receive any more shots.

Before leaving for Virginia, he was put on cholesterol medicine, which he had no trouble with before, that required blood work every month to monitor his body's response. The required blood work was never performed, and he developed an allergic reaction to the medication, which he sustained liver damage and gained 25 pounds during those 10 weeks.

Back at Walter Reed, a doctor ordered an MRI to check on the condition of his shoulder but the case manager refused to do the MRI. Her reason was that it would cost the Army too much money. And the only follow-up on his back injury was the decision of the Army that he suffers from degenerative disk disease, a preexisting condition that they claim is unrelated to injuries overseas.

On October 28, the Army and the National Guard retired him. He suffers from episodes of anxiety, forgetfulness and very bad mood swings. He walks with a cane and with a limp.

Mr. Chairman and members of the committee, American soldiers are injured every day in operations overseas. Every day, family members learn that their loved ones are coming home to them different than when they left.

I'm here for one of them, but I am also here because family members should not have to go through this with a loved one that we have already been through. I thank you again for the opportunity to tell my story.

TIERNEY: Thank you, Mrs. McLeod.

Specialist Jeremy Duncan has opted not to give a statement so much as to respond to questions.

And since we're moving on into the question-and-answer period now, and we'll be under the five-minute rule, alternating from one side to the other, I thought, Specialist Duncan, that I might start just by asking you, if you are willing to talk about it, could you tell us on this panel a little bit about what chain of events led you to become a patient at Walter Reed?

JEREMY DUNCAN: I, myself, was deployed in Iraq, in Samarra, with the 101st 3rd Brigade Reconnaissance (ph). We were doing patrol; came across an IED. I got blown up. And I came here and since then I've had no problems with medical care getting fixed from the problems I had.

TIERNEY: What were the nature of your injuries?

JEREMY DUNCAN: I had a -- fractured my neck, almost lost my left arm. I got (inaudible) lost left ear and lost the sight in the left eye.

TIERNEY: I think many of us first learned of your situation by reading The Washington Post and the description of the physical conditions of Building 18 and the area where you were staying.

Could you tell us on the record here today about those conditions in your room in Building 18?

JEREMY DUNCAN: The conditions in the room in my mind were just, it was unforgivable for anybody to live -- it wasn't fit for anybody to live in a room like that.

I know most soldiers have -- you've just come out of recovery, you have weaker immune systems. The black mold can do damage to people. Holes in the walls. I wouldn't live there, even if I had to. It wasn't fit for anybody.

TIERNEY: What did you do to try to get the room fixed?

JEREMY DUNCAN: I contacted the building manager and informed them there was an issue with my room.

JEREMY DUNCAN: They told me to put it in the system for a work order. I did that. A month went by, I asked them to do it again. He said, put it back in the system. That went on two or three times.

Finally, I had my chain of command from Fort Campbell, who came and visited me -- (inaudible) they made some phone calls, the person over here at Walter Reed -- I don't know where it went. And they still never got fixed. That's when I contacted the Washington Post.

TIERNEY: And after The Washington Post article was published?

JEREMY DUNCAN: I was immediately moved from that room, and the next day they were renovating the room.

TIERNEY: Do you have any personal thoughts about other ways that could be implemented to assist soldiers that are new to the facility here?

JEREMY DUNCAN: As in...

TIERNEY: In how to assist them in the services, the information, and how to get that process working better than it apparently did for you?

JEREMY DUNCAN: Keep following through and keep bugging them about it. Let them know. Just keep letting them know until finally somebody gets sick of it and it finally gets done.

TIERNEY: Mr McLeod, you had a situation of attempting at least to bring attention to Dell's condition and situation. Would you share that with us? Did you make known that you had some issues with his treatment and care? To whom did you go? And what were the results of that?

MCLEOD: I was very persistent. I went to his case manager. She even got tired of dealing with me. I would -- I went as far as the commanders. I went to the generals. Anybody that would listen to me, I would talk.

TIERNEY: Who was the commander here at that point in time? Was it General Farmer?

MCLEOD: General Farmer, yes, sir.

TIERNEY: Did you go to General Farmer and express to him the difficulties?

MCLEOD: Yes, sir, I did. I was on his -- I was at his office door for several days, and each time they turned me around.

TIERNEY: And how do you mean, turned you around?

MCLEOD: They told me he did not have time to talk to me.

MCLEOD: There was other situations present at the time also.

He knew of the situation. He knew of some of the conditions. And each time I went to him they told me that he did not have time, he knew the situation, there was nothing he could do to help me.

TIERNEY: At some point in time, did you have a chance to meet with General Weightman?

MCLEOD: I did. We were sitting in Burger King one day and we were enjoying the day. He had a day of leave. And so we were siting there and the General Weightman walked up.

In my recollection, he's a fine, honorable man. He had nothing to do with our situation. He was, in my perspective, being punished because he caught the tail end of it. Mr. Weightman, in my opinion, he was just shoved into a situation that was already there, and because somebody had to be the fall guy, he was there.

He's never done anything to me. He never knew about my situation. When I asked him questions, he was more than willing to give me answers that I needed.

TIERNEY: I have about a minute left here. We have a rather antiquated system on time watching over here because our lights aren't working.

But, Staff Sergeant, I wanted to ask you, I know that at some point you took matters into your own hands in trying to assist people that were just coming new to the facility. Would you tell us a little bit about what you did and what caused you to take that action?

SHANNON: Well, after the young servicemember died two doors down from me, New Year's of '05, I had been looking at the system as it stood. And we were having at that point up to 100 or over 200 personnel in one platoon, run by one E-7. Typically that type of level of authority is in charge of 30 to 40 personnel. And they had no E-6s -- my job -- underneath them to help them keep accountability of those personnel.

And at that point I started asking my platoon sergeant at the time to give me 25 percent of the people in the platoon and let me help track them. Because they worked long hours just trying to keep track of everyone.

The primary problem with the system, starting with the hospital, is it takes days for the paperwork to catch up with the medical holding company to let them know just that someone has gone outpatient to the Malogne House. I had already been going to my ward on a daily basis to see who was coming and going.

When I asked for a squad leader position, they moved me over to work with a Sergeant First Class Alexander in the OIF/OEF platoon at the time; an outstanding NCO, by the way.

SHANNON: And we implemented a program and eventually received 10 personnel to work underneath us that we check every ward in the hospital every day, receiving the patient report from the aeromedevac office here in the hospital to let us know incoming and outgoing personnel.

We would meet with incoming personnel, identify ourselves, give them business cards, let them know if they had any questions they can contact us. We implemented a program to provide escort from the hospital over to the Mologne House.

And the primary thing, some go to other hospitals. We identified those that were staying here and going outpatient to the Mologne House. When we identified them, then we were able to contact them in the Mologne House and give them, at that time, a proper in processing.

TIERNEY: Thank you very much.

SHANNON: You're welcome.

TIERNEY: Thank you.

Mr. Shays?

SHAYS: Thank you, Mr. Chairman, for holding these hearings and thank you, our witnesses, for coming and testifying under oath. You met with us before and you told us a number of stories that will be helpful to this committee.

I want you, Sergeant Shannon, to just describe one example of the kind of attitude you encountered more often than you should have when you came and asked for information five minutes before an office opened up. Do you remember that story?

SHANNON: Yes.

I have an anger problem. And I think this is common across the board with patients at the hospital. It's something these people are going to go through to some degree or another. And forgive, I've been told there's a time problem and I'm talking quickly.

TIERNEY: You needn't talk quickly. Take your time.

SHANNON: OK.

In the course of the work I did at the hospital, I became very familiar with how things worked at the hospital. I became a person that would take a new soldier around and show them where they needed to go and show them where they needed to go, who they needed to talk to.

SHANNON: Because if I didn't have the answers at that point, I could send them in the direction they needed to go.

SHAYS: And I'm just going to interrupt you. You described that that was quite common, that the soldiers helped other soldiers because...

SHANNON: Yes.

SHAYS: ... they weren't getting the help from a case worker or whomever?

SHANNON: There just wasn't the staff for it at the time. The staff has increased significantly since that time.

SHAYS: OK.

SHANNON: But still not enough staff.

But at that point I was showing a new soldier who was also a patient in ophthalmology down to the office. And it was five minutes before they opened and I just needed to ask the lady if a certain neuro-ophthalmologist worked there.

And she looked me up and down, in my opinion like a piece of dirt, and said, "Come see me when we open."

I won't repeat what I said to her. I cussed a blue streak and it took everything I had not to jump over the counter and smash the printer she was just using to copy something.

SHAYS: Do you feel that that was more typical, or an unusual kind of experience?

SHANNON: Human nature indicates that in the course of any given day in spite of your productivity, you'll have the easiest day you can have, OK?

What needs to not be forgotten here is there's a human issue involved with these guys. And the problem -- and I apologize; I talk a lot these days: It takes me a while to get to the point -- there's a hospital policy that regardless of hours -- this is a written policy at this hospital -- regardless of whether they're on the clock or not, they will always provide assistance to patients when they require it.

I found that out because my wife worked here.

SHAYS: That's the policy. You don't feel it happened?

SHANNON: No.

SHAYS: Let me ask you this: Almost all of you have said the help you received from the doctors when you received help was outstanding.

SHANNON: Yes.

SHAYS: Would you agree, Sergeant -- I mean, Specialist Duncan?

JEREMY DUNCAN: Yes, sir.

SHAYS: Mrs. McLeod, would you agree with that? Or would you?

MCLEOD: Fifty percent, yes.

SHAYS: OK.

Let me ask you this: You got the sense that you were being pushed out of the active Army, the military facilities, to the V.A. Describe to me your attitude about that and why -- what positions you took.

Let me start with you, Specialist Duncan. You don't chose to leave the military.

JEREMY DUNCAN: I'm not leaving the military at all, sir.

SHAYS: OK.

And this is something that's amazing to me. You told the military you had no intention of retiring. What was their reaction?

JEREMY DUNCAN: They were kind of shocked. At first, they were like, "Well, we don't think you can stay in," because of the conditions I had. But, like I said, some of the doctors here helped me find the actual regulations on my conditions, and I meet the requirements to stay in. So, therefore, I'm staying in.

SHAYS: So you don't have an issue of getting help with the V.A. So let me -- but, first, thank you for wanting to stay in; thank you for having to argue to stay in.

Thank you for your incredible service, all of you.

And, Mr. McLeod, thank you, sir.

But let me have both of you, Staff Sergeant and Mrs. McLeod, tell me whether you would prefer to have V.A. help or have the help (inaudible).

MCLEOD: In our situation, the V.A. has absolutely been wonderful to him. But he was only referred to the V.A. because they refused him treatment here.

My goal was to have him to receive his treatment, because I felt that he would receive better treatment when he was on active duty because they stand first priority.

SHAYS: OK. Thank you.

Because I only have 30 seconds left, Sergeant Shannon?

SHANNON: I will receive care anywhere I can get it.

SHAYS: But what are you waiting for right now? Describe to us what you are waiting for right now.

SHANNON: I'm waiting for the plastic surgery to be done, to make my face capable of receiving a prosthetic eye.

SHANNON: And then they will start the procedure to start a prosthetic eye.

They have given me the option to let the V.A. do it. I have a right to have it done before I'm retired. And, as a workaholic, I'm not taking 30 days off from a job to have surgeries done.

SHAYS: You told us your biggest concern. What's your biggest concern right now?

SHANNON: My biggest concern?

SHAYS: Yes, sir.

SHANNON: My biggest concern is having the young men and women that have had their lives shattered in service to their country get taken care of.

SHAYS: Thank you.

SHANNON: That's my biggest concern.

TIERNEY: Thank you, Mr. Shays.

Mr. Waxman?

WAXMAN: Staff Sergeant Shannon, that's your biggest concern, and it's got to be the biggest concern of all Americans. I think that people are shocked when they heard about The Washington Post story of the deplorable conditions here at Walter Reed.

And some of the reactions to those news reports have been, "We never knew things were out of hand."

Now, I can't understand that, when we get officials who say they just didn't know things were happening that were so shocking. Because I have --and I'm going to ask the chairman to make it part of the record -- I have a long list, a stack of reports and articles that sounded the alarm bells about what was going on here and around the country.

For example, in February 2005, Mark Benjamin wrote an article in Salon magazine describing appalling conditions and shocking patterns of neglect in Ward 54 at Walter Reed, the Inpatient Psychiatric Ward.

Another report from Salon, in 2006, warned that soldiers with traumatic brain injuries were not being screened, identified or treated; and others were being misdiagnosed, forced to wait for treatment, or called liars.

And then we have -- in June 2006, Military Times ran a story reporting on problems with the Physical Evaluation Board process. In 2005, Rand issued a very comprehensive report for the secretary of defense, finding that the military disability system is unduly complex and confuses veterans and policymakers alike.

And then the GAO, the Government Accountability Office, found inadequate collaboration between the Pentagon and the Veterans Administration to expedite vocational rehabilitation services for seriously injured servicemembers.

And GAO did some other reports as well. Because in February 2005, GAO reported on gaps in pay and benefits that create financial hardships for injured Army National Guard and Reserve soldiers.

WAXMAN: And in March 2006, GAO warned that a quarter of the active duty soldiers and more than half of Reservists and Guardsmen do not get their cases adjudicated according to Pentagon guidelines.

And in April 2006, GAO reported that military debts posed significant hardships to hundreds of sick and injured soldiers serving in Iraq and Afghanistan.

And in May 2006, GAO issued a report on problems with the transition of care between the Pentagon and the Veterans Administration. And in fact, two weeks ago, the Army inspector general revealed an ongoing investigation of problems with the Physical Evaluation Board system, an investigation which has already identified 87 problems with the medical evaluation system.

Even Congress acted on this issue. The 2007 defense appropriations bill called for Physical Evaluation Board members to document medical evidence justifying disability ratings, rather than simply allowing them to deny disabilities by writing pre-existing conditions -- the kind of problem that your husband had, Mrs. McLeod.

Despite all of these press reports, studies and investigations, it took The Washington Post finally to capture people's attention. They deserve an enormous amount of credit for what they've done.

But, despite all the work that went on before, top Pentagon officials reacted to the reports at Walter Reed two weeks ago by claiming surprise.

Let me just read what the Pentagon's highest civilian official in charge of the military medical program said in a press conference. Dr. William Winkenwerder Jr., the assistant secretary of defense for health affairs, said, "This news caught me, as it did many other people, completely by surprise."

Well, my question for the three of you, or for any of you who wants to respond: What's your reaction to these kinds of statements? What's your response to top military officials when they claim they had no idea that there were any of these kinds of problems?

Sergeant Shannon?

SHANNON: As you will read in my statement, I believe -- implicitly -- in an open-door policy. The biggest problem they have with me is I've been here long enough to see things constantly go up the chain.

To be told -- and I believe that is General Weightman's primary mistake. I don't think he should have been fired, but he said he didn't know. That is not true in my opinion.

WAXMAN: Let me ask Mrs. McLeod, because now I'm going to be running out of time: What's your reaction, when you've been trying to get people's attention to the situation with your husband, and now when we have it so clearly laid out in the press and there's attention being paid to it, the higher-ups say that they were just surprised to hear about all this?

MCLEOD: I have one question: Were they deaf? Because I worked the chain. I went anywhere they would listen. So if you don't want to hear it, you don't want to hear it.

WAXMAN: Specialist Duncan?

JEREMY DUNCAN: There's no way they couldn't have known. I mean, everybody had to have known somewhere. If they wanted to actually look at it or pay attention or believe it, it's up to them.

WAXMAN: There's another statement that I find even more offensive. On January 25, 2005, David Chu, the undersecretary of defense for personnel and readiness, was asked by the Wall Street Journal about the costs of military health insurance and pensions.

In response, he stated, quote: "The amounts have gotten to the point where they are hurtful. They are taking away from the nation's ability to defend itself," end quote.

WAXMAN: What's your view of this statement? Do you believe honoring our servicemembers by ensuring they are properly cared for lessens our nation's ability to defend itself?

MCLEOD: Absolutely not. The cost of care for veterans should not come out of monies that are designated to fight a war. The cost of care for veterans that are wounded in the course of that fighting war should come out of separate funds.

If a certain amount of designated -- I mean, I don't work at that level -- but if a certain amount of money is designated to fight a war, it needs to focus on the war and there needs to be separate funds set aside.

Because if they're going to indicate they don't have the funds to do it well, then, they need to break the issue down. You can't take away from what the soldiers need over there, you can't take away from the soldiers' need over here, and you can't combine the cost because it's too much.

WAXMAN: Undersecretary Guerin welcomed us this morning by saying that there's an Army, military tradition that you leave no wounded soldier behind.

(UNKNOWN): Hoo-ah!

WAXMAN: This sounds to me like this particular man was saying that it's more important to fight even if it means leaving some of our wounded brave men and women and patriots behind in their health care or their disability.

I'm very disturbed by what we're hearing, and I'm glad that Chairman Tierney has convened this hearing right here at Walter Reed.

And from what we're hearing, what's going on here in Walter Reed may be the tip of the iceberg of what's going on all around the country. People are flooding us with complaints that it's not just Walter Reed; check out what's going on all around the country.

And, right now in Los Angeles, the Veterans Administration wants to privatize the land rather than take care of the returnees and the veterans.

Thank you.

TIERNEY: Thank you, Mr. Waxman.

Mr. Davis?

DAVIS: Well, thank you.

And let me thank Mr. Waxman. As you know, a number of those GAO reports this committee requested, some of them coming from complaints from veterans that were stationed right here.

DAVIS: Ms. McLeod, let me start with you.

You went up the chain many times, didn't you?

MCLEOD: Yes, sir.

DAVIS: You finally called this committee you were so upset.

MCLEOD: Sir, I will talk to anybody that would listen. And it took the aid of another soldier who actually heard me cry, saw me cry one day and he says, "This is the number. Make a call." And that's when I called Ms. Washburn (ph). And then you know my story, because you've dealt with me.

Had I not had any other recourse, I wouldn't be here today. The thing of the matter is, Mr. Harvey made a statement made the other day that really bothers me. He said that he hoped The Washington Post was satisfied because they ruined careers.

First, let me come on record by saying I don't care about your career as far as anybody that is in danger. That doesn't bother me.

All I'm trying to do is have my life, the life that I had and that I know. My life was ripped apart that the day my husband was injured. And having to live through the mess that we lived through at Walter Reed has been worse than anything I've ever sacrificed in my life.

DAVIS: Thank you.

She's referring to Grace Washburn (ph) of our staff who's helped us and taking the lead in this when people weren't being paid right. Then they sic the bill collectors on them. People afraid of losing their houses when they come back languishing.

If they didn't have any warnings of this, they weren't paying attention, because as Mr. Waxman noted, we had a number of GAO reports that we authorized -- the GAO calls the balls and strikes for Congress -- showing this was a systematic problem.

Now, I understand that Walter Reed holds town hall meetings. Could each of you tell us about these, who runs these meetings, who attends them, how they're advertised, how often they take place, what types of issues are discussed, and do problems get resolved?

SHANNON: When I first got here, the wives at the Malogne House had started meeting on Thursdays to have a wives meeting to get issues addressed. That started doing some good.

I've been here a long time. The PTSD issues started kicking in. They started having me stay at home. I have never been to a town hall meeting.

I had an opportunity just before the Dana Priest story come out to go to a sensing session for NCOs, and any servicemembers, and I couldn't see the point in it. I've been here too long. It just hasn't done any good. So I didn't go.

DAVIS: Have any of you been to town meetings?

MCLEOD: I was the first wife that actually spoke up. I was the one that actually stated my piece, because they had denied him treatment. They sent him to Virginia for 10 weeks for the brain injury and I looked him -- I looked Colonel Hamilton (ph) in the face and I told him, I said, "You all must have thought you all cured him because you hadn't touched him since he's been back."

My thing is, he opened the floor and I blasted him with everything I had, because I was to the point I really didn't care, because it seemed like I had had enough.

MCLEOD: I was tired of fighting the system. I was tired of trying to help him get well.

At the same time they didn't seem to really care. They wanted him out of here. They wanted to turn him over to the V.A. His case manager at the time was Captain Virginia Long (ph). She got tired of dealing with me when he was in Virginia, because I started calling him three weeks -- calling her three weeks before he come back from Virginia, letting her know what he needed, what he didn't need, what he needed to follow up on.

And she got so aggravated with me because there was a span that I had gone home to try to get things together there that she actually sent him home to keep from having to deal with him. She told me, she said, "I cannot maintain him the way you want to maintain him," she said, "So I'm going to send him home until we can decide what to do with him. And we'll probably turn him over to the V.A."

I fought tooth and nail. That's an old saying for me. Because he should have been taken care of.

DAVIS: Thank you.

TIERNEY: Thank you very much.

Thank you, Mr. Davis.

DAVIS: I'll just ask -- Mr. Duncan wanted to respond to that.

TIERNEY: Sure.

JEREMY DUNCAN: I've never actually been in a town hall meeting myself, sir.

DAVIS: Thank you.

TIERNEY: Mr. Lynch from Massachusetts?

LYNCH: Thank you, Mr. Chairman.

I want to thank Chairman Tierney and Chairman Waxman, and also Ranking Members Shays and Davis, for holding this hearing.

I want to thank the panelists for your willingness to testify and to help this committee with its work. You really are speaking this morning not only for yourselves but everyone else in uniform.

A lot of members up here have been over to Iraq a number of times. I've been over five times and also Afghanistan. I know a lot of these members have gone with me.

And one of the things that always struck me whether we were at the Landstuhl medical facility in Ramstein, or whether we were in Balad visiting very severely wounded young men and women in uniform, they always talked about, "Well, it's going to be OK once I get to Walter Reed."

It was just this gold standard and this confidence and trust in our military personnel that when they got to Walter Reed it was going to be OK.

LYNCH: They were going to get put back together and they were going to have a maximum outcome, whatever their injuries were.

And I think these most recent revelations have been -- well, it's been a real blow to that reputation.

And so the task here for us and together with your help -- and I thank all members of the military who are here today. And I appreciate their service to our country.

Our job today is to make this right. It's not just about doing the right thing. It's about doing the thing right, and making sure that this process works.

One of the things that was stunning to me in going through all the testimony and previous hearings with the veterans groups is that for disability approval within the armed services -- I notice that the Marine Corps -- well, it's actually the Navy, but the Marine Corps approves about 30 percent -- 35 percent of its injured for temporary or permanent disability. The Air Force approves about 24 percent.

Now, the Army, that have the largest number of active duty soldiers and reservists, put less than 4 percent. It's a massive difference. And it can't be just random.

And I know each of you went through this process and also witnessed your fellow in arms together going through this process, and you saw how this was handled. I know the PTSD issue is out there and that we saw less willingness on the part of the military to approve disability based on PTSD.

What do you -- do you see a purposeful effort here to refuse the 30 percent disability that would bring, I think, dignity and the right benefits to those who are injured in uniform? I'd like to just get your sense of it, whether this is a purposeful attempt to deny those benefits to men and women in uniform.

MCLEOD: We were fortunate because I didn't give up.

MCLEOD: They had no intention of even compensating him for the cognitive dysfunction.

Only when we started the med board, they had already done all of his addendums and sent them in. They tested him for his brain injury. With the help of Mr. Davis and Ms. Grace Washburn (ph), they did a congressional investigation and they called me into the office and they -- all the colonels, all the case managers, nurse case manager, my husband's platoon sergeant, commander of the MedHold (inaudible), "What can we do to make this right?"

I said, "Exactly what you should have done to start with. You know, here's a man -- his life's messed up. But you not only messed his life up, you messed mine to. Give us what we need rightfully, and let me go home."

They tested him the very next day. Because when they first tested him, they said he didn't try hard enough. He went from being at Title I math and reading to, six months down the line, he was in special education, according to the Army.

He never was in special education. Before he was injured, he was as smart as most people are. Most children have trouble when they're coming up. I had trouble in math. But believe me, I'm far from being mentally retarded.

When the Army was through with him, they had him down to where he was mentally retarded. And that was on black and white.

So they retested him and they come up to me a week later and they told me, "Mrs. McLeod, we did find something. We found that he was slow. We found that his cognitive skills don't measure up. "

Well, you would have found them to start with if you'd have paid attention.

TIERNEY: Thank you, Mrs. McLeod.

Thank you, Mr. Lynch.

Mr. Platts?

PLATTS: Thank you, Mr. Chairman. I appreciate you and the ranking member holding this hearing. I believe that, as a nation, we certainly have no greater duty and responsibility than caring for those who defend our freedoms.

And it's a privilege to hear the testimony of Staff Sergeant Shannon and Specialist Duncan.

Mrs. McLeod, we appreciate your courage and service on the home front -- Staff Sergeant, Specialist and Mrs. McLeod, your courage and service on the home front and theirs on the war front.

I want to start, Staff Sergeant Shannon. You talk about your specific case. And to make sure I understand the circumstances of when you were first injured, two days later, here at Walter Reed, November 13th, then you arrived here -- three days; November 16th.

SHANNON: First of all, I don't remember the exact dates.

PLATTS: OK.

SHANNON: I was wounded November 13th, and I know I spent two or three days in Landstuhl, but I really don't remember.

PLATTS: Is it safe to say, within a week you'd been transferred here and then discharged to outpatient?

SHANNON: I'm pretty sure I was discharged on the 18th...

PLATTS: OK.

SHANNON: ... which is about three days -- or five days after I was shot, sir.

PLATTS: So five days after being wounded in Iraq, severe injuries, traumatic brain injury, you were discharged to outpatient and basically given a map of where to go and left to be on your own. Is that correct?

SHANNON: Yes, sir. And some of that's my fault. I'm a staff sergeant; I won't stay in bed. Somebody else can have it. Whether I need to be there or not is something I'm qualified to say. I just won't stay...

(LAUGHTER)

PLATTS: Well, we appreciate that can-do approach and wanting to look out for others, but it just is amazing that basically cut loose to that outpatient and without some guidance.

You talked about finally getting in touch with your case manager, and then your case manager did assist in setting up some appointments.

Once you made that contact, what was the give and take between you and your case manager? Did he regularly get in touch with you or it was always you having to pursue them?

SHANNON: The problem was directly related to the breakdown of the system.

Actually my case manager was a lady named Maggie Hardy (ph). She's a wonderful case manager. And after I had finally made contact with her, she, first of all, was wondering where I had been, and yet knowing I hadn't been AWOL because they were tracking my systems in the computer -- my appointment, I was making my appointments in the computer system.

But after I met her, and that became part of my counseling for incoming personnel: know who your case manager is and work with them because they'll keep things happening that need to be happening.

That answer the question?

PLATTS: So the contact, once you established it, then there was a good back and forth between you and her.

SHANNON: Yes, sir.

PLATTS: The gentleman you mentioned, Danny Soto, an independent, how did you come to be in touch with him and what's his official role at the Malogne House?

SHANNON: I've met Danny Soto a number of different times. I'm not sure who he works for. Actually, I think it might be Wounded Warrior...

MCLEOD: DAV.

SHANNON: I'm sorry?

MCLEOD: DAV.

SHANNON: DAV. OK.

But I know that many personnel at the hospital -- or at the Malogne House and the system can speak to the work that he does as an advocate for them in the MEB/PEB process for return to duty, medical discharge or medical retirement.

SHANNON: Like I said, he's just one man. There needs to be an entire staff of people that work outside of a government connection, that have knowledge of how the system is supposed to work and can give us guidance in that system.

Because a huge problem, regardless of what is done here, is to re-earn the trust of the patients here. And I spoke to some of the officers that are working on it. They can fix the problem. And I know, myself, I don't trust it. They have to figure out some way to get me to trust it again.

PLATTS: So Danny Soto would serve as a good example of the type of ombudsman that you think would be wise for those wounded and the families...

SHANNON: Absolutely, sir. He's priceless.

PLATTS: Question -- and Ms. McLeod, in the prior two terms, I chaired the Subcommittee on Financial Management and we saw significant difficulties with the Army on the financial side of dealing with Guard and Reservists.

And I understand your husband was a guardsman, and then activated, right?

MCLEOD: Yes, sir.

PLATTS: Did you feel that it was different treatment because of having been a guardsman family, as opposed to active duty, or do you think it was more across the board, regardless of active duty, Reserve, Guardsman?

MCLEOD: As far as the finance, we didn't have any trouble with the finance, as far as the issues. We did have a soldier that befriended my husband and stole his identity. That kind of finance I had trouble with.

But other than finance issues with the Army...

PLATTS: But the medical issues, such as you referenced a case manager denying the MRI even though the doctor ordered it.

MCLEOD: Right.

PLATTS: Those type of medical issues -- do you think -- did you see a difference -- and Staff Sergeant Shannon, maybe you can answer this, too -- as how active duty soldiers -- was there a difference in how they received care and follow-up, versus Guard and Reserve?

Did that create a problem because of the challenge of managing a very large deployment of Guard and Reservists?

SHANNON: Well, first of all -- I apologize. My...

PLATTS: That's all right. Take your time.

SHANNON: When I was a first here, the medical hold company was all services combined, OK? Now they have two companies, the medical holdover and medical hold. That was very necessary.

But watching them try to go through an additional paperwork process was -- there was no question in my mind that the indicators -- I say things like that because I'm a reconnaissance type -- but the indicators were such that they were having a lot more trouble figuring out the paper trail that is correct for the services they need and the connections they needed with their states in reference to those services.

PLATTS: My time's up.

I want to thank you for your service in taking the personal struggles that each of you've had and turning them into public good through public testimony here today. Thank you.

TIERNEY: Just for the benefit of the members, to let them know, the next speakers will be Mr. Yarmuth, Mr. Duncan, Mr. Braley and Mr. Turner and then on from there.

Mr. Yarmuth?

YARMUTH: Thank you, Mr. Chairman.

And thanks to all three of you for being here today.

And I would like to add my voice to what I'm sure are millions of American voices, who are not only very sorry for the ordeal you've gone through, but also are very angry about it.

I'm glad we had this hearing and I know that eventually we are going to correct the problems that resulted in your situations.

I would also like to say one thing as a former journalist: that it is precisely this type of situation for which the First Amendment was conceived. And I salute The Washington Post, Newsweek, Bob Woodruff and all those who brought this situation to light.

I'm also astounded that it took so long to come to light. These situations apparently are long-standing, and I'm curious as to know -- and this would be for Staff Sergeant Shannon and Specialist Duncan -- what the normal procedure would be for you to raise complaints about the treatment you were getting.

SHANNON: Open-door policy, sir.

Open-door policy works well, as long -- well, if people don't understand the policy, if you concern, a lower level soldier, he takes it to me. If I don't satisfy that concern for him, he has the right to take it above my head. And he continue up the chain until his concern is addressed.

And, first of all, The Washington Post didn't come to speak to me. They came to speak to my wife. She's a person that everyone knows, knows problems that go on here. In the course of that, they met me, and I decided to exercise what in my opinion was the necessary open-door policy for the problems here. It's called public opinion.

Because when a command uses, in my opinion, the open-door policy to keep problems in house -- which is the correct method -- but not to solve those problems -- which is an incorrect method -- then there's got to be a level it can go to that the problem can be fixed.

SHANNON: And my personal understanding of those problems going very high indicated that nobody was going to fix this.

And I'm a leader. My wife reminds me I'm a patient. Those kids -- no offense to the servicemembers -- are going to get taken care of, period.

(CROSSTALK)

JEREMY DUNCAN: I feel the same way. I mean, you address it as high as you can until you get fed up with it and just do what you have to do to get it done.

YARMUTH: I'm curious as to why, however, in this particular case, nobody along the chain of command reacted at all, apparently, to do anything about it, since you all had to go outside the system.

What is it about the mentality there? Did everyone feel complicit in that? Helpless? I'm curious as to why no one in the chain of command would have responded.

JEREMY DUNCAN: I guess they probably -- as they already said -- we didn't know this was happening like this; we didn't have any ideas.

Correct me if I'm wrong, Sergeant.

SHANNON: Sir, I feel the need to say this: They did respond.

And as I read my statement, of course, but the response was indicative of a broken system that's trying to survive. They fired a good man. They fired a few of them. Some of them may have deserved it.

But I've got to say, First Sergeant Walker (ph), the first sergeant of the medical holding company, is someone I've known for awhile and he's gone to bat for us on a daily basis.

I would just personally like to apologize to him. He's a good man and he didn't deserve it, I don't think.

Now, I'm not privy and I don't have a right to know the ins and outs of his case. But a system that fires people down the chain, once again, in my opinion is indicative of a system that is trying to protect itself, whether it fixes the problem or not, and, in my opinion, clearly not focused on fixing the problem.

YARMUTH: About a year ago, I had a situation in which I was on a plane talking to a man who had just come back from Washington, and had visited Walter Reed with a friend of his. And they were talking to a soldier who was from Lexington, Kentucky, had been a postal worker, was in the Guard, was wounded and so forth.

YARMUTH: It was near Christmas time. His life had been disrupted, financial stresses and all those things that we're well aware of now.

And this man to whom I was speaking asked him if there was anything he could for his family or for him for Christmas to make his life easier, and he said, that, yes -- he said, "I'd like some clean T-shirts because it's very cold where I am and they can't afford to give me clean T-shirts."

And I kind of forgot about it at the time, because you hear about Walter Reed and the extraordinary care that's provided here, and I thought it was an kind of an aberration.

I'm wondering how trivial and how many of these situations exist. We've heard of, in the Post series and others, some of the more heinous situations with patients being lost and, obviously, the deaths that have occurred and so forth, but at what level does this stop?

TIERNEY: The gentleman's time has expired.

YARMUTH: Sorry, Mr. Chairman.

TIERNEY: Perhaps one brief answer will suffice.

SHANNON: I can't speak to levels, but when I've got to, you know, get my Purple Heart in civilian clothing and show my Purple Heart to supply just so I can get my uniform, that's broken.

TIERNEY: Thank you.

Mr. Duncan?

JOHN DUNCAN: Thank you very much, Mr. Chairman, and I join the others in thanking you for calling this hearing.

And I want to also thank former Chairman Davis for the great work that he did in this regard, trying to at least start doing something about this.

Let me say first of all, though, that whenever any government agency seems to screw up in some big way, the two things they always say, they always say that their computers and technology wasn't good enough or wasn't up-to-date, which may have far better technology throughout the federal government than most major private businesses; but secondly -- and most often -- we hear the claim that they're underfunded.

I think we need to point out that both the Defense Department and the V.A., but particularly the Defense Department, have received massive increases in funding in the last five or 10 years, mega billions.

And so this is clearly not a shortage -- a problem of money. The Congress has given huge increases to the Defense Department in recent years, and we have tried to say many times that we want plenty of money going for this medical care, as I join all the others in saying this should be the highest priority.

JOHN DUNCAN: And I want to also join others in thanking each of you for coming forward.

But, Ms. McLeod, I noticed that you said you thought General Weightman might be a fall guy.

And then, Sergeant Shannon, you seemed to be less critical of him also. I believe he just came in August.

But in one of The Washington Post stories, it says Congressman Bill Young and his wife stopped visiting the wounded at Walter Reed -- which they were doing, I think, on a weekly basis -- out of frustration.

Young said he voiced concerns to commanders over troubling incidents he witnessed that was rebuffed and ignored. "When Bev and I would bring problems to the attention of authorities at Walter Reed, we were made to feel very uncomfortable."

Beverly Young said she complained to Kiley several times. She once visited a soldier who was lying in urine on his mattress pad in the hospital. When a nurse ignored her, Young said, "I went flying down to Kevin Kiley's office again and got nowhere. He has skirted this stuff for five years and blamed everyone else."

Did you find this to be true, that everybody was blaming somebody else with the problems that you had? I will ask each of you.

MCLEOD: I feel that everybody's passing the buck. You go to one, and they say, "Well, it's not my problem; you need to go to so and so."

I did everything but camp out, I mean, honestly. And if I could get away with that, I probably would have done that too.

You can't keep looking and not getting answers.

JOHN DUNCAN: Sergeant Shannon?

SHANNON: It's difficult for me to speak about people passing the buck. It's something that has surprised me by virtue of this story coming out in The Post, because I didn't want to see anybody fired, just wanted to see the problem get fixed.

I work at my level. I'm good at working at my level. I know that, on a constant basis, things were passed to higher.

JOHN DUNCAN: Well, let me ask you this: The subheadlines in the main Washington Post story said "bureaucratic bungling" and it said "frustration at every turn."

Do you think those are accurate descriptions of what you ran into?

SHANNON: Absolutely. The bottom line is, like the situation I know of, a young man missing his entire right arm, that the Army has seen fit to award 10 percent disability, because he's going to receive 80 percent of the use of his arm with his prosthetic.

SHANNON: That's the bottom line, sir.

JOHN DUNCAN: One of these stories says General Kiley lives right across the street from Building 18, which is apparently the worst example of what's going on here.

Did any of the three of you, did you see these top generals and the top brass here getting out and going around and observing what was going on? Or do you feel like they stayed isolated in their offices and just meeting with their staff people?

JEREMY DUNCAN: After the article came out, there was a lot of people visiting Building 18 and looking into it. That was after the article came out. Before then, it was occasionally a commander coming through to check on everybody, make sure everything's going right. It wasn't, like, overwhelmed as it is now. But before, just no -- a feel people going in and check on everybody, say, "Hey, how's everybody doing?"

JOHN DUNCAN: Well, that's what I was talking about was before the articles came out.

Let me just -- I know my time's about to run out, but let me say this: It's not just members of congress up here who are upset about this. I tell you, it's people all over the whole country. And they are very upset about this. And I think all of are going to demand that action be taken.

Thank you very much, Mr. Chairman.

TIERNEY: Thank you, Mr. Duncan.

Mr. Braley?

BRALEY: Staff Sergeant Shannon, Mrs. McLeod, and Specialist Duncan, thank you for your courage in coming here today and sharing your stories with us.

I'm here because my brother Brian works a kinesiotherapist at the V.A. hospital in Knoxville, Iowa, taking care of patients every day. And I know that every member who provides medical and psychiatric care to veterans is tainted by the stories we're talking about here today. Every person in a V.A. system should want these problems solved, so that we get back to having pride in the facilities that take care of our veterans.

One of the things that I'm not at all shocked about is the fact that case managers may be playing a role in denying access to veterans to the benefits that they're entitled to. Because I'm familiar with the AMA guides to permanent evaluation. I'm familiar with the DSM4 criteria that are used.

BRALEY: And I've represented veterans and their families in life and disability claims.

And one of the things that has been known for a long time is that case managers have two functions: one is to return a worker to workforce as quickly as possible; and, two, to minimize the cost to the employer of returning them to work. Those don't work at the same level of advocacy that patients need.

And what I'd like to know, is there anybody who serves the role as an ombudsman or as a patient advocate here at Walter Reed in assisting patients with these claims?

SHANNON: My first experience with that -- and I apologize; I talk too much. But my first experience with that was working with my initial PEBLO counselor, and he gave me all the information about, "Hey, you need to educate yourself about this process, because once this is done, it's done. And if you miss something you're entitled to, it's gone."

And so based on his knowledge of this system, I said, "OK, well, tell me what I need to do or tell me who to talk to." And he just had to smile at me and say, "I don't know who you should to talk to. They all retired and gone." At that point, I was no longer able to trust my PEBLO counselor in the process.

Danny Soto, once again, is a person outside of the system who is knowledgeable of the system. He is someone that we can trust because, based on what I consider an automatic conflict of interest: the PEBLO and the MEB/PEB process, both work for the same organization, the United States government.

BRALEY: Mrs. McLeod, one of the reasons I am concerned about what we are hearing today from you is that part of the response to the problems here at Walter Reed was to propose adding 39 additional case managers to assist with the processing of these disability claims.

And to me, what we're talking about is a solution to the problems that you and others have shared, is making sure there are people outside the case managers who are here to assist veterans and their families negotiate the difficult process of qualifying for and receiving an official determination of whether or not they are entitled to disability benefits.

Would you care to comment on that?

MCLEOD: My feeling is, if the doctor feels it's necessary to run a test, it's not the case manager's job to second-guess that. If it were, she would be in the doctor's place. I went to my husband's case manager, I begged her when -- on April 19th he was supposed to have set up the MRI to have it scheduled. He got that MRI June 23rd, when I took him myself.

MCLEOD: The case managers need to stop playing doctor and they need to be case managers. They're supposed to get them where they need to go, schedule the appointments and stop questioning it.

But instead, his case manager, Captain Virginia Long (ph), got so upset at me, she sent him home to keep from having to deal with him.

Now -- but she got quick enough. Whenever I put in the resources that I did, she gave him a physical in her office. Now, we're talking sanitary -- have you seen those offices? The last thing you want to be doing is examining in the office.

I won't tell you how mad I got, and I won't tell you the things that I said. But the treatment that she gave him before I had her fired as his case manager, a dog wouldn't have deserved.

BRALEY: Do the three of you know, does the JAG Corps provide any type of legal assistance to veterans who are processing disability claims?

SHANNON; I don't know about processing disability claims. But the JAG has been very helpful here, just in the course of my wife's vehicle being repossessed, the vehicle that I owned prior going to combat, and my not knowing -- I couldn't remember who to send payments to and stuff after I was wounded -- contacting those companies and getting the message across that we've been wounded and to give them time to catch up.

So I'm not sure about processing claims, but they're there and they have done good work for me.

MCLEOD: The only time I dealt with the JAG was during the episode where the guy tapped into all our accounts, when he stole my husband's identity. And they told me that it was not an issue for them; that I had to go through Finance.

TIERNEY: I thank the gentleman.

Mr. Turner?

TURNER: Thank you, Mr. Chairman.

Mr. Chairman, I want to thank you and, of course, Ranking Member Davis, for your efforts in trying to insure that we have quality medical care and the services that we need for our men and women who have served our country.

Staff Sergeant Shannon, Mrs. McLeod, Specialist Duncan, I want to personally thank you for your service and what you have done, not just in trying to ensure that there's appropriate care here but in making certain that the word is known as to what needs to be done.

You've got a great deal of courage, and you have certainly brought things to light that have saddened many people across the country.

I know that you're aware that the next panel, and then the third panel, that we have people that are going to come in and speak about this issue, who have various degrees of accountability or various degrees of answers.

We have General Kiley, General Weightman. We have General Schoomaker and General Cody.

What would you like to hear from them? And what type of questions would you like to hear them answer, with the issues that you've brought forward?

SHANNON: On their level, at this point, this is about accountability. Like I said, you know, I'm a firm believer in the Peter Principle: Don't ask me to work in a job I'm not qualified to do.

This has no reflection on whether they're qualified to do it, but it reflects directly on my ability to speak to what they should do.

I just want them to fix the problem.

In fact, I personally got a little angry when Harvey resigned. Now, I don't know how things work in Washington, D.C., but in combat, we don't get to resign when bullets are flying and people are dying.

SHANNON: Now, the way that reflects on this issue is that this is a political war, to some degree, on a daily basis. And when they're receiving political incoming rounds in the course of helping us or and in the course of dereliction of duty in that requirement, they continue to fight for us until they're fired. Pull themselves up by their bootstraps like any sergeant would do, admit to their mistakes and work to fix them until they're fired.

TURNER: Mrs. McLeod?

MCLEOD: On my level, as far as the family members are concerned, I'd like them to answer to the family, to say, "We can guarantee." That's what I want, I want a guarantee that not anybody would have to go through what I went through; that, "We're going to listen and we're going to take charge."

JEREMY DUNCAN: Me, I'd like to hear them actually say they're going to fix the problem, not just cover up what they're trying to do, make it, you know, sound like, "Hey, yes, we're fixing Building 18; all it is is paint and spackle." That doesn't fix. It just covers up. Just fix it, like they're trying to do now, you just need to fix it from the ground up, get it fixed so it's fit to live in.

TURNER: Thank you.

Thank you, Mr. Chairman.

TIERNEY: Well, thank you.

Ms. McCollum?

MCCOLLUM: Thank you, Mr. Chairman. Thank you for holding this meeting.

I'd like to thank the people who are testifying. I'd like to thank all of those who served our country. We need to show our thanks. We need to show it through respect and the way we welcome our veterans and their families home.

We're not doing a very good job, and that's why we're having this hearing.

I first became aware that the system at the V.A. level had challenges and was broken by being the daughter of a disabled veteran and watching benefits erode away; talking to veterans in my community about long waits, lack of equipment.

They knew when they saw the overworked staff, however, they were going to get the best of care. But it was having the ability to see the staff.

I'm very concerned about a lot of issues, but I want to follow up on one. And if you don't mind, Staff Sergeant, I'm going to quote from your full testimony.

Quote, "I've been lost in the system. I want to leave this place. I have seen so many soldiers get so frustrated with the process they will sign anything presented just so they can get on with their lives.

MCCOLLUM: "By signing documentation without fighting for the benefits they've earned, they are agreeing in writing to the Army's determination of their benefits."

And, as Mr. Lynch pointed out, the Army's only at 4 percent in determining benefits.

We almost have no advocacy -- that's not working for the government; no one that we can talk to about this process, no one who's knowledgeable and that we can trust who is going to give us fair treatment and informed guidance.

The physical evaluation counselors -- the MEP and the PEB -- both work for the government and have its interest at heart, not ours.

Mr. Lynch had been quoting from a document that he had. And I'd like to add a little more to what the staff sergeant just said in his own words, and then ask a question.

Each branch of the military provides for opportunities for injured servicemembers to challenge their ratings. Most of the injured simply pocket their severance checks and go home. Only 20 percent of the soldiers ask for formal hearings at which an attorney can present evidence and call witnesses. As the Army says, only half of those soldiers proceed with hearings.

Perhaps that indicates most injured soldiers are satisfied with their ratings. But veterans groups say more wounded servicemembers would challenge the ratings if it wasn't so complicated and time- consuming.

MCCOLLUM: Most of those hurt in the line of duty are young, weary of fighting and anxious to return home to their civilian lives.

And in other words -- and these are my own words -- the severance check can look really quick and a lot less painful at times, not realizing the benefits that they have been signing away.

I would ask you to tell us if you know of any pressures that you have either heard of or witnessed for people to sign away their benefits, and what we need to do in order to make sure that veterans know, either by providing an ombudsperson or whatever, that their rights will be protected, we do welcome them home and we do respect them.

MCLEOD: I'll take that one.

I know a soldier, fairly young, maybe early 20s, who was deployed. I took this soldier under my wing whenever we met, and he was a great guy. Very nice. He told his recruiter that he had had an episode in high school, and the Army took him anyway. They sent him to Iraq.

When he got back to Walter Reed, they diagnosed him with bipolar, but he was pre-existing. The Army gave him 0 percent. This guy has nothing. He's trying to find his way back into society and may never be what he was. So they gave him 0 percent.

This is how we treat our soldiers. We give them nothing, but they're good and tough to go and sacrifice their lives. And we give them nothing.

You need to fix the system; compensate where it's needed. This soldier needs care.

Yes, so they are treated, but the V.A. will treat them according to the ratings of the Army, because the first thing they ask, "What was your rating with the Army?" You get in a category. We were fortunate because my fight still continues. They know me first-name basis.

But what about the ones that don't have me? What about the ones that don't have a wife or a mother or a father that can stand up for them?

If you're good enough to go, you're good enough to be taken care of when you leave here. We need to take care of those that took care of us.

(UNKNOWN): Hoo-ah!

TIERNEY: Thank you, Mrs. McCollum.

Ms. Foxx?

FOXX: Thank you, Mr. Chairman, and I want to thank all of the folks who are here today, and all of our military people who are here for being willing to serve, to protect our rights to be here.

I am very interested in the issue of accountability, and I realize that, throughout our society, we have people who are unresponsive.

FOXX: We see it every day in the personnel in the Congress.

I will tell you that there are people who work throughout government agencies who don't always react the way they should react, particularly to other staff people.

What I'm interested in is: How do we fix the system? Casting blame doesn't do us any good if we aren't fixing the system.

Sergeant Shannon, Ms. McLeod, Specialist Duncan, do you have some specific recommendations to make? And you don't have to tell them to us today. But do you have some specific recommendations that you can make on how the system can be better, so that it's fixed?

And I'm particularly interested in: How do we assign responsibility in order to have accountability? It seems to me that the biggest complaint you all have made is this passing-the-buck complaint.

So, how can we establish a system that says: You've been to someone, you've asked a question, it is, in your mind, the responsibility of that person to take care of that problem, and they don't do it.

Unless we're willing to fire people who are either incompetent or unresponsive, then what alternatives do we have to trying to solve the problems that we are seeing?

SHANNON: I believe I can speak directly to that, based on the military system that I've grown to know so well myself.

Any noncommissioned officer can tell you that you don't just give people instructions to do things, you supervise them, OK?

SHANNON: A person can be getting close to a position where they need to be fired. However, with proper supervision, they can be brought back in line.

This directly relates to priorities, in my opinion, and the breaking of the story has changed priorities. And now things are getting done.

The priorities of the people above that need to be supervising what is done below them on a daily basis can be changed so that they are not supervising at the level they need to be supervising at.

If I were doing that at my level, I'd be in danger of getting fired in my job.

Like any system, whether it be a civilian or military, at a point you see someone that's having a problem doing their job correctly, you counsel them. And if they still can't do it, you counsel them again.

I believe it's three times, then they're fired.

But that requires proper supervision, ma'am. And if supervision's not happening, you know, how can you counsel someone if you're really not watching what they're doing?

FOXX: The others? If you...

MCLEOD: In my situation, for example, my husband went to a doctor. The doctor roughed him up pretty good. Finally, I wind up having to take him to the emergency room because he couldn't move for three days.

We filed a complaint.

When the patient rep call me, first she wouldn't talk to me. And then my husband said, "You need to talk to my wife; she can explain to you more."

I told her what happened. And she asks me -- she says, "Are you sure?"

I said, "Yes. I wouldn't have filed the complaint if I hadn't have been sure."

She says, "Well, I'm sorry on behalf of the hospital. Sometimes things like this happen."

No, it doesn't happen. When they tell you that's all they can do, that's all (inaudible).

We have doctors -- let me specify: he has doctors -- that were so eager to fight for the system, they made him able to move. They put him in the emergency room, but they made him able to move because they wanted to fight for the Army.

We need to turn around. We need to fight for the soldier. The soldier is the reason you have a job.

MCLEOD: When they go to the case manager, there shouldn't be second-guessing. They should say, "OK, we'll put you where you need to be. We'll get the doctor." When you go to the doctor and he says, "OK, we need to do this," you have to go back to the case manager, she has to set up everything. There shouldn't be, "Well, I'll talk to the doctor." No problem. This needs to be taken care of.

You need to start treating the soldiers like citizens, like the same representative anybody would want. You go to your doctor, you don't want him to second-guess you, you want him to find the problem, you want him to get a result. That's what you go to him for. That's exactly the same thing they need to do.

They need to start at the very bottom first and find out why they can't do their job to the capacity they need to do. You need to work your way up the system. When you find the broken link, you either put some glue on it and fix it or you get rid of it.

TIERNEY: Thank you very much.

Mr. Cooper?

COOPER: Thank you, Mr. Chairman.

And thanks to each one of the witnesses for your outstanding testimony.

If there are this many problems in Building 18, how about Buildings 1 through 17, or buildings with higher numbers? We need to make sure that we're getting to all the problems here at Walter Reed.

Are there any other facilities or personnel issues that we need to know about?

JEREMY DUNCAN: From my understanding, I just got currently moved over to Building 14 myself, as of Friday. Our complaint for people living in 18 didn't want to move, because over in Building 18 we had free cable and there were computers downstairs.

From my understanding, now they're moving TVs and computers over into Building 14. How long that's going to take, I'm not sure, but they're just trying to make it better now from the issues we've had before.

And everybody was comparing Building 14 with 18. There's no comparison. Building 18, honestly, I hate to say, it was like ghetto. It was tore up. It had nothing. But it had the stuff that we like to have.

Building 14 was luxury, but it didn't have the same things we had over in 18, which now they're fixing. So, in my opinion, they're starting to make it look better.

Everything's turning back toward the Malogne House. The Malogne House was like -- if you've been in the Malogne House and you moved out, you hated it. But you lived in the Malogne House, you were living the life. It was great. You had a kitchen downstairs, had food and everything, ready to go.

So, I mean, they're trying to make it better. I will give them that. But that's going to take a while for them to do that.

COOPER: The U.S. government, under the so-called BRAC round, has scheduled the closure of all of Walter Reed in a few years and to move everything over to the Bethesda campus.

COOPER: What opinion, if any, do you have about that shutdown of this entire facility and move over to the Bethesda campus?

JEREMY DUNCAN: Like I was telling the press, there's no reason -- you can't use that for an excuse: "We're closing down in so many years."

There are still soldiers coming in today and tomorrow and the next day; that the stuff needs to get fixed here now before those problems get worse for the new soldiers coming in.

Myself, I've got two months left here at Walter Reed and then I'm going back to my unit. I'm not sure how long Sergeant Shannon has. But I'm sure, when he leaves, the guy behind him is not going to live in the same conditions or deal with the same problems that we're having now.

Those need to get fixed before Walter Reed closes down. That's not an excuse.

COOPER: Thank you, Mr. Chairman.

TIERNEY: Thank you, Mr. Cooper.

Mr. Van Hollen?

VAN HOLLEN: Thank you, Mr. Chairman.

I want to thank all of the witnesses for testifying as well and add my voice to those who have thanked you and your families for your service to the country and the sacrifices you have made.

And, as Mrs. McLeod said, you know, you and your loved one's been fighting a war; you shouldn't have to come back here and fight a system. And I think that's absolutely correct.

And we need to make sure that the system provides you the respect you need. And what we've heard, unfortunately, is a system that has been providing more neglect than respect, at least with respect to outpatients that we're dealing with.

And as others have said, I think you've done a terrific service to the country. And if you look at the front page of today's Washington Post, you'll find that, because of the issues you've raised here at Walter Reed, others around the country who are facing similar circumstances will have their voices heard and will be empowered now.

So you have done a great service not just here at Walter Reed, but around the country as well.

We all hear from time to time about those insurance companies that tell people, you know, "We want to take care of you when you're in trouble," and advertise as such. But, when the time comes to pay claims, for certain insurance companies, they're not there. And they try and make their money -- make their savings by denying claims.

That's clearly not a model that we want the United States government and U.S. military to be following.

VAN HOLLEN: But from your testimony about your own personal circumstances, as well as other stories, as well as reports from the GAO and others, clearly when it comes to disability claims, it does appear that the system has been stacked against individuals like yourself and your loved ones.

Mr. Waxman quoted from a statement Mr. Chu made in 2005 suggesting that the health care we have to provide to our veterans is somehow a burden on the system that we somehow shouldn't be having to deal with.

Let me ask you with respect to the system itself: GAO essentially has said -- and I do want to mention their report -- in conclusion -- they issued a long report about the disability -- military disability evaluation system back in 2006. They concluded that, "DOD is not adequately monitoring disability evaluation outcomes in reserve and active duty disability cases," and said that there had been a lack of training, a lack of monitoring, and a lack of oversight.

And it's clearly an area I think this committee is going to be taking a look at, and other members of Congress, other committees in Congress.

Do you have any specific recommendations with respect to that disability system, which clearly seems to be designed more to, essentially, put an overwhelming burden on the individual seeking to show that their disabilities have been related to their service and not providing an ample opportunity for the individual? I don't know if you have specific recommendations with respect to that process.

MCLEOD: Well, that process, like I said, we were fortunate, and we took the compensation because he got the 50 percent.

The thing about it is, they never acknowledged that he has a brain injury. So they didn't compensate -- they compensated for the cognitive disorder.

My thing is, they're so busy trying to make everything acceptable -- several things on his med board was acceptable, but they still retired him. How can everything be acceptable if you're going to be retired?

MCLEOD: That's a little contradictory to me.

They gave him -- for the anxiety and for the cognitive disorder, they gave him the 30 percent with the attitude, in April of next year, when we have to come back, he's going to be better.

Well, if he's better -- which I really at this point don't see happening -- if he's better, he'll lose that rating and guess what? He'll get a severance package. And then he'll have nothing.

I don't think -- if the injury warrants it, I don't think there ought to be a TDRL. The brain injury is permanent. What they've told him is, compensatory measures. If he hadn't had a brain injury, why we they teaching him compensation measures to help him out? That's contradictory again.

My thing is, if you warrant a compensation, it ought to be permanent, not something you've got to bargain for 18 months down the road. And then we may not have insurance. Then we're going to have to get all his treatment at the V.A.

What about families? What are they supposed to do?

I'll have nothing. But all because we still have to bargain up to five years with the Army. He didn't bargain when he signed the line, he didn't bargain when he got injured. Why are you bargaining now?

VAN HOLLEN: Thank you, Mrs. McLeod.

Thank you.

TIERNEY: Mr. Hodes?

HODES: Thank you, Mr. Chairman. Thank you for holding these hearings.

And to the witnesses, thank you so much. You have been very brave. And your courage is being heard around the country now. And it's very important -- what you have done in shedding light on what's going on here is very important.

And I know that the feelings that we feel hearing what you're saying are only a very small, little piece of the feelings you've felt and what you've gone through. So thank you for being here.

Staff Sergeant Shannon, I want to ask you, you've talked about the help you got from Danny Soto. Do you think that there needs to be some independent office or agency that is committed to fighting for the soldiers in this system?

SHANNON: Yes, I do.

SHANNON: And, to clarify, I haven't received any help from Danny Soto yet. I have guided other people to him and I am sure he's helped many others. But I have not been able to start the MEB process -- sorry; to make it easier to understand: the medical retirement process -- because of the hold-ups I've gone through.

And when I get to that point, I'll be looking him up.

HODES: Thanks for that clarification.

Mrs. McLeod, do you think there needs to be some independent office or agency that fights for the soldier in this system, whose only duty is to the soldier and not to the system but to the soldier?

MCLEOD: I think you ought to stop giving it to the committees and give it to the families. That's who you need to be talking to. Give it to the ones that have to deal with day in and day out.

HODES: What do you think the best way for us to give that power, if you will, to the families would be, in your opinion?

MCLEOD: There needs to be a committee formed with a couple of spouses, a couple of people that have the power to get the things done. There needs to be a forum set up to say, "OK, we'll research the families and the situations. We know, because we've been there."

And we need to set action into force. This is what they said they need. Lay it against exactly where we are today and give them what they need instead of sitting there waiting on somebody else to do it.

HODES: Specialist Duncan?

JEREMY DUNCAN: I really have nothing to say on that matter. I mean, I'm not going through the same process as they are. So I mean...

HODES: Thanks.

Staff Sergeant Shannon, your picture appeared on the front page of The Washington Post.

SHANNON: Right.

HODES: Before your picture appeared, I understand that you were reporting to formation once to week. Is that correct?

SHANNON: That's correct.

HODES: After your picture appeared, my understanding is that you were ordered to report to formation daily.

HODES: Is that correct?

SHANNON: That is correct.

HODES: And who gave you that order, after your picture appeared, to report daily to formation?

SHANNON: Those instructions were passed on to me by my platoon sergeant. He said they came from the sergeant major.

HODES: And did you inquire about the reason for your being ordered to report to formation daily after your picture appeared in The Washington Post?

SHANNON: I just follow orders.

HODES: Did you consider that retribution against you for going public with your story?

SHANNON: I really couldn't say. I mean, they tell me to stay home because I tend to break things if I hang around too much, and I don't work well in complex environments.

So when they told me that, I'm like, "Fine." And the next time I decide to break somebody's arm or smash a piece of furniture or something, they'll just tell me to go back to my room again.

HODES: Specialist Duncan, have you experienced anything that you think might be retribution for your going public?

JEREMY DUNCAN: I can't say exactly maybe for sure it yes but, I mean, all of a sudden moving of rooms, moving from building to building, just all of a sudden quickly -- all I asked them to do was fix the walls, not move me a million times. (inaudible) some soldiers, I'm tired of moving rooms. I've acquired a lot of things being here for a year, and moving's not fun anymore. I'm just tired of moving here, moving there. I just want you to fix it so I can deal with it.

HODES: Mrs. McLeod, you had to end up coming to a member of Congress to get help for your situation.

MCLEOD: Yes, sir. After that, I think they were afraid to retaliate.

HODES: Thank you.

Thank you all very much.

TIERNEY: Thank you, Mr. Hodes.

Mr. Welch?

WELCH: Thank you, Mr. Chairman.

I just want to thank the witnesses. I'm at the end of the line here, and I want to tell you that it's been a very moving experience for me to hear each of you tell your stories.

My concern is that this is the tip of the iceberg. My concern is that there is a culture of disregard that has no place in how we treat wounded veterans. And my concern is that there is a lack of commitment to recognize the obvious, and that is that the cost of the war has to include the cost of caring for the warrior.

I'm going to yield the balance of my time because I appreciate that you have been answering lots of questions, and my questions have been asked and very eloquently answered. So I thank you for your service.

TIERNEY: Thank you, Mr. Welch.

Mr. Cummings?

CUMMINGS: Thank you very much, Mr. Chairman.

I, too, thank all of you for being here today. And as I listened to your testimony, I just said to myself: This should not be happening in America. It sounds as if we have a system which should be in intensive care and appears that we're putting Band-Aids on it.

And, as I listened to you, you know, I was just wondering, you know, in another hearing, in another committee -- I sit on Armed Services also, and we had, Sergeant Shannon -- and to all of you -- some testimony that there was a lack of psychiatrists and mental health people in the military, and that they were trying to find more.

CUMMINGS: The mental health piece of the treatment here, how have you found that?

JEREMY DUNCAN: I've had no problems with it, sir.

CUMMINGS: Have you, Sergeant Shannon?

SHANNON: Well, I have a big problem with their mental health thing, starting with their traumatic brain injury testing, OK?

First of all, they tell me I have no loss of cognitive function. Well, how can they do that if they give me a traumatic brain injury test that, in my opinion, my six-year-old son could pass, because it's designed for severely traumatically brain-injured people.

I know myself, and I know I have paid a price for the brain injury I received. And if they can't even take the time to bounce scores from tests I could take today that I've taken before and see what the difference is, I've got a big problem with that.

Now, the counseling and everything that they give, from the psychiatrist to the psychologist, PTSD counseling, I believe they're running a tremendous program. And we have access to a program called Polytrauma Recovery, and it's a tremendous program run out of the Washington, D.C., V.A.

However, the biggest problem they have is none of the servicemembers will receive benefit from that program until each individual soldier has reached a mental state where they're willing to go seek that treatment.

CUMMINGS: One of the questions that I've asked some members of the Joint Chiefs of Staff in this other hearing -- it went to the Bob Woodruff piece that ran on ABC News a few nights ago with regard to brain trauma and trauma to the head, and how people can get treatment here at Walter Reed, for example, but then when they go back to their rural areas or wherever they may go, to small towns or whatever, they were not able to get follow up, and so they found themselves going backwards.

Is that a concern of yours, Staff Sergeant?

SHANNON: Absolutely. It is very much a concern of mine, for me, starting with the beginning of the process of seeking the treatment, where I was told, "Well, you're not a bad enough brain injury to need the Polytrauma Recovery."

SHANNON: And I, you know, I got angry enough I had to get up and leave. Usually when I've gotten angry and -- well, I'm a sergeant -- bad language starts coming out of my mouth. And that's the point where I know a trigger's coming and I'm going to get violent.

But they tell me I don't have a bad enough brain injury to need treatment. I have found out, since then, I'm clearly a level two polytrauma recovery person -- the point being that proper supervision would be the word I would have to use in relation to that subject.

They have discovered that men suffer post-traumatic stress disorder symptoms from concussive force to their heads. We get mortared every day over there, depending on where we're working.

Just because a guy's not got a visible injury doesn't mean he hasn't got PTSD.

CUMMINGS: What about you, Ms. McLeod, with regards to your husband?

MCLEOD: When my husband was here, they gave him psychological evaluation treatment because they thought it was just a transition problem. I kept fighting and fighting. I knew there was something wrong. When they sent him to Virginia, he was treated there as well.

When he came back, he got so out of hand that a friend of ours, who her husband's a brain injury patient, she actually took him to her husband's psychiatrist. And that's how he got settled with a psychiatrist.

They never offered him any psychiatric treatment.

CUMMINGS: Well, let me say this, that -- I have about 30 seconds left -- what I'm hoping for is that we will not -- or not us, but even other congressmen in five years -- will not be sitting here going through these same things.

Hopefully, with Secretary Gates looking at this system and having this system revamped, we'll be able to resolve a lot of these problems.

And we thank you very, very much for you service. And we can do better as a country. We must do better.

MCLEOD: Thank you.

TIERNEY: Thank you, Mr. Cummings.

Ms. Norton?

NORTON: Thank you very much, Mr. Chairman. And I thank you, and Chairman Tierney, and Ranking Member Davis and Shays for your courtesy.

I'm a member of the full committee, not of this subcommittee. I'm very proud of this hospital all my life. Have been proud to have it in my district. I just want to say, for the record: All the indications are that it is still the crown jewel; it's still the state of the art hospital on the planet for treating soldiers like you.

To say thank you for your service sounds so shallow after what you've gone through, both in battle and here, that I want to just move first to Ms. McLeod. Because thank you for service -- it must include you, who have been apparently a volunteer caseworker with considerable family sacrifice, having to give up home and job to come here.

NORTON: I was very concerned you said, "What about those who don't have me?" Because that's what I've been thinking as a mother the whole time: What about those who don't have Mrs. McLeod?

May I ask, I mean, when you said you didn't even know -- you weren't even informed when your husband was wounded, were you ever officially informed that he was wounded?

MCLEOD: No.

NORTON: Unbelievable. So somehow...

MCLEOD: No one from the Army ever picked up the telephone and called and said, "There's been an accident." Nobody called me. He called me himself.

NORTON: This, I think, points to the systemic nature of the problem. It begins on the battlefield and carries through throughout the life of a soldier.

Let me ask you, all three of you, roughly -- you cannot know, you've not done a census, but you have been around this hospital. Roughly what percentage of soldiers are here without family, are here by themselves?

JEREMY DUNCAN: I would say about 25 percent or so, maybe less. I've seen a lot of people here just by themselves...

NORTON: Twenty-five percent are here with family?

JEREMY DUNCAN: Without.

NORTON: Without family.

JEREMY DUNCAN: It could be less.

NORTON: So 75 percent of the soldiers here have some family here. Is that your sense as well?

SHANNON: I'm not sure I would go that high, but definitely in the high range.

And one of the things that I believe is being discovered right now is that having a caring family member close during this time of recovery is incredibly beneficial to these soldiers as they go through this process.

These people understand them. Sometimes they are not coherent, based on medications and things, and it takes someone with intimate knowledge of that individual and how they were on a daily basis before to understand some of what they're trying to get across and some of what they're going through based on their knowledge of them before.

NORTON: Mrs. McLeod, I appreciate what you said about, well, you know, leave it to the families, because families obviously want to take care of their folks. But the fac