The Broken Soldier

Our frustration has reached a boiling point. My unit and the state authorities charged with granting approval for medical care are playing games. I’d refer to them as ‘language games,’ but that would imply a degree of sophistication their keystone cop-esque bumbling doesn’t quite merit. Still, it is difficult for me to believe people capable of graduating high school, driving cars, dressing and feeding themselves, etc., people you’d expect to have I.Q.s somewhere in the neighborhood of the mean, could really be as dumb as their behaviors suggest. Each time we approach the unit or the state for authorization of medical care, given my approved Line of Duty (which took seven months to conclude, by the way), we are given a set of conditions to meet: Prescriptions, medical records, doctor’s notes, and what not. My wife and I meet those conditions, usually at the cost of our time, patience, and money - all things we have in short supply, and without fail the bar is pushed back a bit further.

When my LoD was first approved, we made very clear to the unit and the state my doctor’s plan of action. This included referral to a pain management specialist, physical therapy, and referral to a neurosurgeon. My symptoms, from May of this year to the present, are consistent with cauda equina syndrome - considered a surgical emergency. Since that time pain and neurological symptoms have moved up my back to cervical and thoracic regions of my spine. This is not uncommon, or so says my doctor, in severe back injuries left untreated. Our bodies try to adjust to the injury, and in so doing create new injuries. I am experiencing weakness and tingling in both of my hands and arms, and am also having symptoms consistent with cervical angina (a/k/a pseudoangina), that is to say, shortness of breath and tightness in my chest. My unit was given my complete medical record, all prescriptions, and every other piece of information requested. They claim, though I’m not in a position to verify, to have sent all information to the state for review and authorization. That was a month ago.

When I called my unit last week for my weekly check-in, something I was ordered to do to hasten and facilitate a good outcome, I was told the hold up was due to the dates on most of the medical documents received. That is to say, most of the documents requesting pain management and neurosurgery referrals are from May, June, July, and August. This puzzled me. What do those authorizing medical care believe has changed with regard to my condition and the need for immediate medical attention? Especially in light of other medical documentation, also submitted to the unit and to state authorities, describing my condition as ‘permanent’ in nature, and describing my prognosis as ‘fair’ - when taken in context of an approved LoD means having moderate to moderately severe symptoms for the rest of my life if prompt and unlimited access to medical care is granted. The unit RNCO had no explanation. She suggested I submit any additional documents I had or would have directly to the state approval authorities.  So much for my calls hastening and facilitating a good outcome.

Last week I sent scripts for a neurosurgery consult from my most recent medical appointment. (This doctor, not my usual doc, did leg raises and other tests used in assessing possible spinal injuries (something the active Army DO didn’t do, but, in fairness to the Army DO, this doctor didn’t type my symptoms into WebMD, so … yeah).  He suggested I get an MRI.  I told him I had one.  He looked at it, read the diagnosis, and immediately wrote another script, the one mentioned above, to a neurosurgeon.)  A primary care visit authorized by the state for my Line of Duty injury. This authorization allowed me to visit the doctor, but didn’t authorize any of the treatments he prescribed. My wife and I are still paying for treatments out of pocket, in spite of having an approved LoD injury. I paid $100 for 10 days worth of pain medications - which, given that I have been on pain meds for seven months, the pool of drugs available to me is growing smaller and smaller by the day. As risk of addiction, if I’m not already addicted, is a very real possibility. To date, neither my wife or I have heard anything from them. This is amazing.

Now I am no fan of frivolous government spending. I understand the need to justify costs. But this is absurd. This process, the LoD, is meant to simultaneously verify service members’ claims of injury incurred while receiving pay and allowances and also minimize costs associated, obviously, with fraud and/or malingering. But in the seven months I waited for my Lod to reach its conclusion, which, given that I didn’t enter WTC with light urinary and bowel incontinence or the need to walk with a cane should have been a slam-dunk, the federal government completely betrayed the spirit of this process and its intended purpose. What was a moderate to severe injury, but one from which I could have somewhat recovered with prompt and adequate treatment, is now a permanent disability. And with the approved LoD the government is on the hook. Average costs of minimally invasive neurosurgery is, ballpark, $5,000-$30,000, including post-op care. More radical surgery, which I will likely need, is about 2-5 times as expensive. As well, if 38 U.S.C. (part of the DoD codified laws regulating how services and the VA assign disability ratings) is any predictor, which, if the government is doing what it should do is a good predictor I will be close to 100% disabled (probably awarded 100% disability as I can no longer perform most of the jobs, physical in nature, on my CV). Now the government is in to me for $2,500/month non-taxable income (with increases for purchase parity over the course of my life), plus allowances and other benefits (awards for a paralyzed foot, for example), re-educating me (beyond my triple bachelors and grad work), and all medical care for the rest of my life. I will likely also declare property tax exemption for our home - an additional $3k/year the state government will have to do without.  Various levels of government are now obligated to me in the millions - that is, if I live to be an average age.  And what’s worse, the situation this has created for my family and I is terrible too. We, the government and my family and I, are both losers in this. We are losers because of this broken system, and the incompetent, needlessly suspicious and adversarial, and unsympathetic people executing it.  Something has got to give.

It’s been a few weeks since we handed over the doctor’s prescriptions for the pain management clinic (and an epidural). We still haven’t received approved to actually have those scripts filled. Apparently doctor’s notes are required as well.

So we continue to wait. There has still been so response from our local representative - or any other government representatives.

As much as I don’t want to admit it, I really don’t think the military or the larger government really cares at all about these soldiers. My husband continues to endure more pain that most people can handle and he does it 24 hours a day.

The strength of a true solider is awe inspiring.