Combat Zone-Wounded DoD Civilian Employees Slip Through Health Care System Cracks, Too

From Friday's NBC News In Depth, this segment explains the frustration felt by some civilian employees working alongside the military who are injured in the combat zone.



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In the interest of education, article quoted from extensively.

Last month, the Washington Post also reported on Mike Helms' journey as an Army civilian caught up in the red tape and indifference that waited for him after he was injured in Iraq in the second year of the war:

Traveling through Sunni insurgent territory north of Baghdad, the U.S. military convoy was nearing a base when a roadside bomb ripped into the lead Humvee, leaving its gunner, Mike Helms, bleeding and swaying from a strap in the open back.

Helms, 31, a civilian counterintelligence expert with the Army's 902nd Military Intelligence Group, had been sent to Iraq in 2004 to help fill a critical intelligence gap in the area known as the Sunni Triangle. While in Iraq, he lived with soldiers and ate military rations, took fire from mortar rounds and small arms, and clocked hundreds of miles manning a machine gun on the back of a Humvee.

Then, on June 16, 2004, came his IED blast injury.

What followed was a three-year battle with a system where common sense and decency seem to have been trumped by insane bureaucracy and jurisdiction rules. Rules that are clearly outdated in a war where thousands of government contractors, state department diplomats, 'weekend warriors' of the National Guard and Reserves, and civilian workers like Helms in addition to the 'regular' fighting force, our military's active troops.

As the wars in Iraq and Afghanistan strain the U.S. military, the Pentagon is sending civilian workers such as Helms into war zones to provide critical support to the troops, raising questions about their status and treatment.

Several thousand Defense Department civilian employees -- with about 3,300 of them from the Army -- are serving in Iraq and Afghanistan, according to Pentagon data. Since 2001, about 7,500 DOD civilians have worked in those combat zones or in anti-terrorism capacities elsewhere, including seven who died there and 118 who were injured. "We must use government civilians . . . to fill out the force or we could not do our job right now," said Gary J. Motsek, assistant deputy undersecretary of defense for program support. He called the civilians "unheralded patriots."

How is it that Helms -- who was not a combat soldier -- was manning a machine gun on the day his convoy came under attack?

[H]aving served three tours in the Balkans from 1996 to 2001, he thought that he could help inexperienced soldiers. "We were going into combat, and we had guys who had never shot these weapons," he said. Because the 902nd task force was not part of a scheduled deployment, it lacked such basic equipment as Humvees and rifles. "I needed to train them as best I could," Helms said.

A civilian colleague of Helms's who previously spent 20 years in military intelligence on active duty explained: "Civilians went out because we were experienced. The young soldiers had no experience with radios, with weapons." As a result, Helms and other civilians took turns manning the M-60 on convoys. On June 16, it was his turn.

A new nightmare was waiting for the man who would receive the Secretary of Defense Medal for the Defense of Freedom (the civilian version of the Purple Heart) for his combat zone injuries.

Evacuated to the U.S. military base at Landstuhl, Germany, Helms was improperly coded as a civilian contractor, so he was turned away from Walter Reed after he arrived there. "They wouldn't admit me or give me a room," said Helms, who moved in with the wounded sergeant who was driving his Humvee. "They left me sitting in the waiting room." After about a month of ad hoc care, the sergeant moved out and Helms also left.

"This was the first in a series of problems resulting in Mr. Helms being denied timely treatment within military treatment facilities in the U.S.," according to a November 2004 memo by Kimmons. It found "systemic failures in the provision of medical treatment to civilian employees who are injured in the line of duty."

Under Pentagon policy, DOD civilians evacuated to a military medical facility in the United States because of injury or illness "may receive medical treatment in the military medical system or they can be transported to a civilian medical treatment facility of their choice."

That choice -- and so many others -- was out of Helms' reach.

Care has been slow and uncoordinated, as civilian doctors with little experience treating combat wounds have handled his ear injuries, broken tailbone and nerve damage. "There is no consistent care at all," he said.

Doctors at the Defense and Veterans Brain Injury Center later diagnosed Helms's brain injury, but overall he has received limited care from military facilities. The Army declined to discuss his case, citing privacy laws, but said that "the Army assists injured Army civilian employees, and helps them seek the care and benefits they are entitled to as Federal employees." It said that in the case of an IED injury, a case worker at Walter Reed should coordinate civilian care, which Helms says never happened. ...

"I am on Month Six waiting to see a behavioral specialist and internal medical doctor, and on the first month of waiting for a sleep doctor," he said, adding that the person who approves his workers' comp claims at the Labor Department "works only on Thursday and does not have voice mail, e-mail or fax."

Helms wears hearing aids and suffers from short-term memory loss, irritability and post-traumatic stress disorder. He said that he survives mainly on maple-flavored instant oatmeal and Gatorade because his medication-racked system cannot tolerate anything else.

He pulled out a laminated card that he uses to keep track of seven medications he takes for sleep, nausea, depression, anxiety and PTSD. "No one will change my meds," he said, because he lacks a primary-care doctor capable of managing all his injuries and ailments.

One can only hope that this saga is no longer replaying itself.

Have these problems been worked out of the system by now? Are there any new Mike Helmses just embarking on the ordeal that he has had to endure the past three years?


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