Wednesday, June 9, 2010

Some Things Just Make Me Mad

I had not intended to put up a blog today. I wanted to leave the last one about the attack on the USS Liberty up for one more day because I feel it is an important topic (you can still find it directly below this posting). That changed when I learned the following story. This is the kind of thing that results when you allow mindless bureaucrats to run programs and hire employees who are not encouraged to actually think about their jobs or responsibilities but are, instead, rewarded by the quantity and not the quality of their work product. What follows is an example of the harm that a mindless, cold bureaucracy can inflict.

Ryan Hallberg suffered a loss when he was injured by a roadside bomb in Iraq. He lost his right leg 4 inches below the knee when an IED
exploded under his passing Humvee.

Despite the amputation, Hallberg has twice been denied a $50,000 insurance benefit because he has been told by the federal insurance office administering the program that "there is not enough medical information to support your loss."

Unfortunately, this is not a single case. As outrageous as it sounds there are cases emerging across the country about the same program, established five years ago to address the growing number of troops coming hope with traumatic injuries from Iraq and Afghanistan. U.S. Sen. Amy Klobuchar, a Minnesota Democrat whose office has become involved in Hallberg's case, called it an example of "government bureaucracy gone amok." The Government Accountability Office is well aware of the ongoing problem. They conducted a resent audit that was highly critical of how claims from the program have been denied.

While one branch of the government has provided Hallberg, who lives in Andover, Minn., with a prosthetic leg and rehabilitation at 90 percent disability, another has denied his claims for a loss.

As he heads to Walter Reed Hospital in Washington, D.C., for three weeks of fitting for a new prosthetic, his expenses have soared as he has taken unpaid time off from his job as a Coon Rapids community services officer. "You're holding $50,000 from me that I rightfully earned by donating a limb to this nation. So why wouldn't I fight for it?" said Hallberg, 26, who left the military as a staff sergeant.

Adding to the insulting nature of this case is the fact that Hallberg was riding as a gunner in Iraq, attached to an Army Reserve unit, after taking the place of another soldier who Hallberg had switched his leave with to allow the soldier to go home to see the birth of his child. The convoy was taking a general to a meeting from Baghdad to Fallujah and had encountered a roadside bomb en route. Hallberg's unit wanted to spend the night in Fallujah and return the next day after the road had been cleared. Instead, the general ordered the unit to proceed.

Hallberg has haunting video of the attack. From a Humvee gun truck several vehicles away, the video shows a plume of black smoke appearing in the middle of the road. Gunfire from the .50-calibers begins immediately as the trailing truck passes through the plume, spent cartridges spitting out on the hood. Hallberg's Humvee can be seen slowing to a stop. A lone soldier runs back to the disabled Humvee. Both of Hallberg's legs had been shattered in the blast, which injured all four passengers. One of the soldiers died en route to medical care.

Hallberg's mother, Cheryl Berg Wineman, found herself immersed in the trauma of her son's injuries - and in the flood of paperwork that followed. Included among the benefits was an insurance plan, Traumatic Servicemembers' Group Life Insurance, an entitlement that members of the military enroll in with monthly premiums.

Congress started the program, known as TSGLI, in 2005. Like commercial accidental death and dismemberment policies for civilians, it was intended to provide a quick lump sum benefit to help address the financial burdens facing service members before they start receiving veterans' benefits. The benefits can range from $25,000 to $100,000 depending on the type of injury.

Hallberg, who earned a Purple Heart for his injuries, qualified for $50,000 in a one-time payment for the damage to his legs. Anxious to return home, he left Walter Reed in early May to return to Minnesota, where his family performed many of the duties the hospital staff had done. Hallberg returned to Walter Reed in mid-June to have the metal halo ring and pins removed from his leg and to begin physical therapy. And that's where the bureaucratic problems begin.

The doctor's medical chart of the visit has been misplaced, although a social worker and several other personnel have since recalled Hallberg's visit. Without the documentation, the Office of Servicemembers' Group Life Insurance denied his claim, which could amount to as much as $50,000 in additional compensation for being unable to perform daily living functions such as dressing or showering.

"They wanted documentation. Who was taking care of him when he as home? We were," Berg Wineman said.

After learning of his situation, Klobuchar's office sought and received a letter from a surgeon at Walter Reed confirming that Hallberg's condition was such at the time of his recovery that he would have been unable to perform enough of the daily living functions. Still, without actual documentation, the case has stalled. Hallberg's right leg was amputated a year and a half after the explosion. He hopes one day to become a police officer.

As in Hallberg's case, a 2009 audit from the Government Accountability Office raised several concerns about how the program was administered and the denial of claims. It found a lack of quality assurance that claims decisions were accurate, consistent and timely, and that the Department of Defense and the Department of Veterans Affairs, which both administer the program, lacked reliable data for overseeing claims.

It also found no sufficient explanation for why approval rates varied among the branches of services, with the Marines getting a much higher approval rate than the Army's - 67 percent for the Marines compared with 53 percent for the Army.

Representatives from the Office of Servicemembers' Group Life Insurance said improvements have been made in reviewing claims. For fiscal year 2009, the overall approval rate is 73 percent, with the Marines, Air Force and Navy rates between 73 and 81 percent. The Army, which files the most claims, has an approval rate of 67 percent. There are no incentives for a branch of service to deny or approve claims.

"We have an old motto: 'Pay if you can, deny if you must, but don't let the cases gather dust,' " said Stephen Wurtz, a deputy assistant director for the Office of Servicemembers' Group Life Insurance. "" (-somebody please hand me a bucket)

Hallberg's latest denial came May 5 and he returned to Walter Reed on June 8.

Klobuchar has spoken with Secretary of Veterans Affairs Eric Shinseki about the need to make improvements but predicts cases such as Hallberg's are likely to increase.

As more and more soldiers come back with injuries the government bureaucracy still hasn't been able to cope with how to give them the benefits they deserve.


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