There is a systematic failure in both Department of Defense (DoD) and Department of Veterans Affairs (VA) programs designed to address the medical and overall readjustment needs of war veterans. There is no plan to gather usable data and monitor the 1.5 million deployed Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) service members as they return to duty or reintegrate into civilian society. The continued incomplete process of reintegrating soldiers, especially Guard and Reserve Soldiers is an indicator of continued process deficiencies.
DoD currently requires service members to answer a limited questionnaire to determine if they need to be referred for treatment upon their return from a combat theater. Soldiers are typically rushed to return home after a deployment and do not necessarily give these questions sufficient attention, nor have they changed gears from mission first mentality.
I returned from OIF as a Reservist in 2005. DoD had no provision for me or any member of my unit to obtain physicals or evaluation. As individually mobilized Reserve Soldiers we were swiftly processed, lock step, over 4 days at Ft. Bliss and shipped home. I went to the VA about a month after my return to civilian life (had to take leave from my civilian job) and in the course of trying to get my initial medical screen was assaulted by a Phlebotomist at the Clinic. So the Bottom line - no medical exam, check-up, evaluation, etc... for this Reserve Soldier. My story is not unique and many others can be found online... DoD and VA net effort to identify, treat and reintegrate is near zero and broken.
As a status check if the system we see the reported rise in the backlog of more than 100,000 claims in two years. The continued absence of consistently prompt mental health referrals as part of Post-Deployment Health Assessment process. Half as many members of the Guard and Reserve file disability claims as compared to active duty veterans and these claims are rejected at twice the rate. Frankly, after 24 years in the Army Reserve, I don’t have a clue how to even start a claim, nor is anyone inclined to step up and assist as I’m now retired.
I believe its time to insist that VA and DoD better coordinate efforts and become more proactive. Efforts to effectively share medical information are underway but still far short of what is needed. My medical records from the mobilization were unceremoniously put in an envelope and mailed to my house… no one reviewed, followed up or checked them. I could not get a physical or even medical attention at Bliss within the month I returned as facilities were overwhelmed. The effort at that post at the time being nearly completely invested in those getting ready to deploy. To be fair DoD should conduct mandatory in-person physical and mental health exams with every service member 30 to 90 days after deployment.
The current system still reflects a bias that was relevant before Guard and Reserve soldiers became part of an operational reserve. Little has been done to change the support structure for Reserve component unique challenges in either the VA or DoD. Efforts to integrate the resources of DoD and the VA must be continued beyond sharing medical data to include a true plan of action for citizen soldiers health care in light of the greater reliance of the nation upon their services.