Sunday, October 24, 2004

The New York Times > National > Part-Time Soldiers, Injured but Not Yet Home

The New York Times > National > Part-Time Soldiers, Injured but Not Yet Home:
"Staff Sgt. Jeffrey A. Elliott returned to this country with a back injury after his unarmored truck hit a roadside bomb in Iraq. Yet 15 months later, he still has not made it home for good.

A member of the Washington National Guard, Sergeant Elliott is hoping to finish whatever treatments may soothe the degenerating disk in his back and for the military to complete the paperwork for his case, now promised within weeks. He is living out of a suitcase in a barracks while his wife and children wait, 220 miles away.

Under a web of Army rules, Sergeant Elliott and thousands of other part-timers injured on duty are navigating a system suited to full-time soldiers. Most are required to stay on a military base to get government medical treatment, to collect their active-duty salaries and to finish military evaluations that will decide whether they return to duty or leave with severance or disability payments."

Full-time soldiers recuperating with Sergeant Elliott have to wait, too, but they have lives here - their spouses and children, their churches and their jobs. Long before Iraq, they lived on the base or just down the road.

The rules are affecting a growing number of part-time soldiers, as the military is deploying the National Guard and Reserves in Iraq, Afghanistan and elsewhere at rates unprecedented since World War II.

Many of the injured say they have grown embittered from being away from home so long. Some see the extended separations as one more indication that military leaders consider the needs of part-time soldiers - once taunted as weekend warriors - as less important than those of the full-time troops.

They view themselves as casualties not just of bombs and heart attacks and ankle twists, but also of poor planning for a war that is increasingly being fought by the nation's part-time military.

In March, a year after the war began, after thousands of part-time soldiers had already returned home sick or wounded, and as complaints began emerging from homesick soldiers, the military said it would begin a test program to let some part-timers receive active-duty pay while being treated at hospitals and Veterans Affairs sites closer to their homes. But even now, only a few are actually receiving that service.

Since January 2003, more than 16,000 reservists and guardsmen have been placed on "medical holdover" - waiting for treatment and the military to decide if they are fit for duty - either because of injuries overseas or because of medical problems found while they were training to be deployed. Of the 4,240 part-time soldiers now on such status, 904 are being treated in their own communities under the Army's Community Based Health Care Initiative. Many others, including residents of more than half the states across the country, cannot even apply.

Col. Barbara J. Scherb, who oversees the initiative for the Army Forces Command, was asked why military leaders had not planned a way for reservists and guardsmen to be treated near their homes before now. "No one really thought much about this before," she replied.

Colonel Scherb described the slim participation in the program. "I think a lot of it is because it's new," she said in a telephone interview, "and, quite candidly, because we're sort of making this up as we go along."

Some of the waiting soldiers, at Fort Lewis and at other bases, said that they had never heard of Colonel Scherb's program or had learned of only one or two soldiers who had been allowed to join it.

Many said they had become resigned to living apart from their families for unknown months more - even longer, in some cases, than their colleagues who served complete stints in Iraq.

Most of the injured find themselves back on the base where their unit first assembled before going overseas. Others are flown to other bases because of a military hospital's medical specialty, and some have been delivered to bases closer - not always close, but closer - to home. Officials at Fort Lewis say many of their injured part-time soldiers live near the base, which is 45 miles from Seattle.

But data from the office of the Army's surgeon general show that some Oregon guardsmen, for example, are recovering in Fort Bliss, Tex.; some part-time soldiers from Wyoming and Florida are on medical holdover in Fort Dix, N.J.; and a handful of New Jersey troops are at Fort Riley, Kan.

"Unfortunately, the timetable of the soldier wanting to go home may not correspond with the treatment they need," said Jaime Cavazos, the spokesman for the Army Medical Command. "We're trying to provide them with the care they need."

Unlike the most gravely injured soldiers, receiving round-the-clock treatment at the finest military hospitals, these are ordinary soldiers with more ordinary wounds. The loneliest and the impatient can elect to go home, even if they still need medical attention. But that can be an expensive trade-off; military rules dictate that they lose their active-duty salaries even though they may still be too injured or ill to return to their civilian jobs.

Someone who leaves active duty and seeks treatment from his own doctors qualifies for military medical insurance, known as Tricare, for only six months. Advocates for the National Guard say one in five guardsmen lacks medical insurance from his regular job, leaving no room for health problems that may linger.

Political and military leaders have pledged to make Veterans Affairs benefits, including access to the 157 V.A. hospitals and 845 clinics across the country, available to Iraq war veterans for two years, but most soldiers are not eligible until they are retired from military service or discharged from active duty.

There have been exceptions to the rule, V.A. officials said, but only in cases when the Department of Defense has chosen to refer a soldier to the V.A. for care.
It is uncertain how much it would cost the Army to allow all part-time soldiers to receive their pay as well as their treatments at home. Some say the military would save in housing expenses, but would be unable to control health care costs. For now, military officials say they are unsure even what the medical costs will be for their current community-treatment program.

The requirements for that program are numerous. A soldier's home must be in one of 23 participating states; he must live near a private medical facility or a V.A. hospital suited to treat his particular problem and accepting Tricare; if he is capable of any work, which most of these soldiers are, he must live near an armory, recruiting station or another military facility for work, and the military must not have begun the process of determining whether he is no longer able to be a soldier - which can take months.

Military leaders began considering such a program, Colonel Scherb said, after they realized there might soon be overcrowding of part-time soldiers at military bases around the country. There is room for only 5,000 of these injured soldiers at bases, she said, and the numbers were mounting by late last year. Fort Lewis had also begun its own similar, smaller program for "remote care" late last year, a program Sergeant Elliott said he was allowed to join briefly.

In recent weeks, the numbers of those allowed to go home for treatment while still receiving active-duty pay has grown significantly, Colonel Scherb said, and she expects that to continue rising.

"Everybody is committed to making this work," she said.

But the future of the program seems uncertain. Announcing it in March, the Army described it as temporary, saying, "Once the number of soldiers needing care drops to a level that can be managed from Army posts, the program will be reduced or closed."

I think no more need be said.
con·cept: The New York Times > National > Part-Time Soldiers, Injured but Not Yet Home