Treatment Options for Wounded Warriors

October 22, 2008 at 10:41 pm | Posted in Deployment, Disabilities, Military, Rehabilitation | 4 Comments

There is little doubt that traumatic brain injuries (TBI) and polytrauma are the signature injuries among veterans of OEF and OIF.  The nature of the injuries, the numbers of servicemembers experiencing them, and the lifetime impact of these injuries on the lives of individual servicemembers and their families have had a profound impact on rehabilitation systems of care, both within the VA and in the civilian sector.

DOD and the VA system have established new initiatives, including the development of the VAs polytrauma system of care and significant DOD funding for research with direct relevance to the treatment and rehabilitation of servicemembers with TBI and polytrauma.  In addition, the public profile and support  of the Defense and Veterans Brain Injury Center , the Center for Deployment Psychology and the Center for the Study of Traumatic Stress are increasing.

Clearly DOD and the VA are taking steps to ramp-up the research and clinical care capabilities within their systems for these populations.  However, as anyone who has ever worked within or tried to work with large governmental organizations knows, change comes slowly.  In the meantime, there are countless numbers of returning servicemembers who need services now.  Many of them are being served well through the VA system, but it seems that not very many understand that there are additional treatment options.

The Houston Chronicle recently published an article on Project Victory.  This project is a unique collaboration between the VA system and a very well established civilian rehabilitation hospital, funded through a private foundation. TIRR (The Institute for Rehabilitation Research) is regularly highly ranked on the national rankings of rehabilitation hospitals by US News & World Report.  TIRR has a reputation for programs that emphasize the importance of treating symptoms and deficits which impact all aspects of community re-integration for individuals with disabilities (e.g. return to work, social relationships, etc.).  Project Victory is designed to assist veterans and active duty servicemembers with mild to severe traumatic brain injuries by providing assessment, treatment for impairments and conditions resulting from the TBI, and specific vocational and educational services.

There are many well established civilian rehabilitation hospitals with significant experience levels (and success) in treating TBI.  What I don’t think many servicemembers realize is that these civilian hospitals are a treatment option for them.  At least they are while the servicemembers are still on active duty.  You see, any hospital that participates in Medicare/Medicaid is required by law to accept Tricare for inpatient treatment.  Rehabilitation hospitals wouldn’t survive long without payments from Medicare/Medicaid.  Thus, it is unlikely that a rehabilitation hospital would not accept Tricare.  This is why active duty servicemebers are being treated at civilian rehabilitation hospitals.

Given how long the medical discharge/retirement process can take (the MEB is another truly special governmental process), treatment through civilian hospitals is an action that can be pursued.  I don’t think a lot of families understand this option though (they are often the ones making the treatment decision, not the injured servicemember) and I wonder how pro-active staff at the military hospitals are with respect to educating patients and their families about this treatment option.  Conversely, it could be that the huge delays in medically discharging and/or retiring servicemembers that the press has castigated the military for are actually numbers that are inflated because the military is keeping the injured servicemembers on active duty status while they receive treatment in civilian facilities.  It’s hard to tell just what might be happening from the outside.



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  1. So… you mean there is help for me after all.

  2. Gunner! It’s nice to hear from you. You don’t need help silly :) On a serious note, I sincerely hope you never need the kind of help provided through these programs.

  3. Hey wait, he doesn’t even comment on my blog! He did call though, so I will cut him some slack.

  4. Don’t be too hard on him ABW. I didn’t think he even read my blog anymore and he’s never called me from Iraq ;)

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