December 23, 2008 – At a recent gathering in a small auditorium at Fort Lee, Va., wounded soldiers listened as everyone in their chain of command up to a full colonel reassured them that life in the post’s Warrior Transition Unit remained good.
Capt. David Payne, their company commander, reminded them that Fort Lee had ranked in the top five of 35 WTUs for 15 straight months, according to monthly online polls. The barracks are “rated the top in the Army.” Three members of the cadre are former wounded soldiers themselves.
Lt. Col. Robert Lather told them the hospital is being revamped, with more space dedicated to active-duty soldiers so they don’t have to wait in long lines with troops going through Advanced Individual Training.
“Your mission is to heal,” said Col. Donna Diamond, head of Fort Lee’s Kenner Army Health Clinic. “We’re here to make sure your needs are addressed.”
In the back of the room, Sgt. Loyd Sawyer shook his head.
“We’re having another dog-and-pony show,” he said.
Before the meeting, troops were told their attendance was mandatory, and they needed a doctor’s note to get out of going. After the meeting, soldiers seen talking to reporters — or even surreptitiously passing notes with phone numbers — said they were called in by their chain of command and asked about what they had said.
“The town hall meetings are never like that,” said 1st Lt. Rebecca Ludwick, one of about 70 injured soldiers assigned to the WTU. “I’ve never seen all those officers there.”
The disparities didn’t end there. As officers from the unit explained that they were fully staffed, that the cadre is well-trained and cares, and that the troops consider their chain of command friends, the soldiers offered a different story: They can’t get appointments; they are forced to perform 24-hour duty while on sleeping medications; they say they are treated as whiners trying to get over on the system; they say training injuries are treated as less important than combat injuries, even though by law, both require the same medical care.
Two said they sought off-post counseling to help them deal with the stress of being in the WTU. One with severe post-traumatic stress disorder went back to the hospital as an inpatient after a cadre member yelled at him for playing with his unit patch.
One said she was named the executive officer of the unit, even though she injured herself during initial training and had no command experience. Another faced an Article 15 for oversleeping — even as he was going through a sleep study that eventually diagnosed him with narcolepsy.
They say that when they ask for help — through an ombudsman, the Wounded Warrior hotline or through the Inspector General office — they are admonished for violating the chain of command.
The Army created Warrior Transition Units after the scandal at Walter Reed Army Medical Center, Washington, D.C., in early 2007 after investigations showed that soldiers working their ways through the military medical retirement system had to fight through a thick bureaucracy of lost paperwork, incorrect documents, untrained lawyers and counselors, and unfair ratings that left them with a lifetime of injuries and little or no compensation.
It was revealed that sick and injured soldiers served as platoon sergeants and squad leaders even as they took medications or dealt with mental health issues. Some spent months — even years — in medical hold units. Ultimately, many signed whatever they were handed so they could go home.
The 35 Warrior Transition Units, formed about a year and a half ago, include professional cadre pulled in to provide stability; nurse case managers assigned to monitor soldiers’ progress and appointments; a doctor just for the soldiers in the unit; and family resources. They have ombudsmen and case managers. Everyone, officials say, has been trained in the special needs for soldiers with PTSD or traumatic brain injury.
But in recent months, the Army realized it does not have the manpower to staff the units, the rules changed about who would be allowed in, and the focus shifted to those with combat injuries rather than those who injure themselves preparing to deploy. Those who don’t go to a Warrior Transition Unit remain in their home units, where unfit soldiers fill deployable slots — leaving line units understaffed as they prepare for deployment to Iraq or Afghanistan.
The offshoot, Fort Lee soldiers say, is that those without combat injuries are treated as if they are a waste of resources.
Payne disagreed. “They’re treated the same,” he said. “From what I understand, everyone’s treated exactly the same.”
Brig. Gen. Gary Cheek, director of the Army’s Warrior Care and Transition Office, told a meeting of the Association of the U.S. Army in October that “our focus is on soldiers with complex medical needs.”
‘I’m sick of being hassled’
Retired Army Lt. Col. Mike Parker, who has worked as an advocate for wounded soldiers by helping them through the medical retirement process, said he sees the same recurring issues in the Army’s WTUs. “Fort Lee’s probably one of the worst of the bunch, but it’s happening all over the place,” he said.
He and other veterans’ advocates say they see errors in medical retirement paperwork, incorrect information about what benefits soldiers are eligible for, and soldiers being forced out for pre-existing mental health conditions and disciplinary problems that directly relate to their military service.
Some of Parker’s concerns surfaced at the Fort Lee town hall meeting.
Ludwick asked why all of her medical conditions were not properly documented on her medical form. Lather explained that he had called for guidance and been told that only medically unacceptable conditions should be on the form, and that the Physical Evaluation Board at Walter Reed was kicking back packets that listed all conditions.
That’s wrong, Parker said, after talking with board officials. All conditions should be listed.
Sgt. Stanley Craig stood up at the meeting to ask why he was given 24-hour staff duty when he was on sleeping medication.
“Many people … function on the same medications you take,” Lather replied. Payne told him to talk with a platoon sergeant.
Diamond said her staff is doing a good job. “I’ve not heard any complaints on the cadre at all,” she said. “I think people understand they genuinely care.”
Payne is a former patient who broke his leg after stepping in a gopher hole at Fort Riley, Kan. A Medical Evaluation Board found him fit for duty. He had two surgeries to repair the leg.
“When I got here, I was still dealing with my own issues,” he said. “I didn’t really have specific Warrior Transition training.”
He did have his cadre train online, and had substance abuse and mental health counselors give classes.
Because the WTU is not a typical unit — no arms room, no motor pool — he feels his role is more akin to that of a parent.
And the soldiers say they often do, in fact, feel like children.
One soldier who asked not to be named said he had a meltdown one day because of his PTSD and asked his nurse case manager to make him a mental health appointment.
But she didn’t. Rather, she had him committed to the Veterans Affairs mental health clinic at Portsmouth, Va., where he was immediately released, he said, because the doctors said there was no need for him to be committed.
He began seeing a counselor, but was told he couldn’t go to his second appointment because he had made the appointment himself, rather than having his case manager do it.
When he arrived at Fort Lee from another unit, he said it took 6½ weeks to restart his physical therapy, and then a month to get an appointment for an MRI.
Then, he said, his nurse case manager told him she was too busy and that he needed to make his own appointments for anything not related to his medical retirement case.
“They’re blaming me for prolonging my medical care,” he said. “I’m ready to go home. I’m sick of being hassled. I can’t stop shaking.”
Craig arrived at the WTU after serving two tours at Aberdeen Proving Ground, Md., as a mortuary affairs specialist. He blew out his knee on an obstacle course 2½ years ago. Then, in October 2007, while training to deploy, he fell off a truck and suffered multiple herniated discs. Doctors realized immediately he was not deployable.
At Fort Lee, he said he hasn’t seen his nurse case manager for more than a month, but was told he can’t make his own appointments.
When he stepped in a hole Labor Day weekend and broke a bone in his ankle, he received a referral for a doctor’s appointment from the unit’s primary care physician. He gave it to his nurse case manager, who told him to make the appointment himself, he said. He finally got the appointment in mid-November.
The paperwork related to his Medical Evaluation Board was a disaster, he said, and when he tried to explain it to the cadre, they didn’t understand what he was talking about.
His original separation date was August. He’s been extended until Dec. 30 because of his medical retirement case. He just received his final paperwork for his medical evaluation board. He was rated at 10 percent for his knee and 10 percent for his back, which his paperwork states he hurt picking up a footlocker several years ago — a noncombat-related injury. His training injury that caused the herniated discs had been left off.
“I specifically remember falling out of a truck,” Craig said sarcastically. “I’m so fed up with this place.”
He said he just signed the paperwork to get it over with.
‘They want you to give up’
Sawyer’s wife, Andrea, begged for her husband to be admitted to the hospital when he didn’t get the help he needed for his severe PTSD. He had been at Joint Base Balad in Iraq on the day a Turkish airliner crashed and killed 45 people about 1,000 yards from the mortuary where he worked. The staff spent hours cataloging belongings and lining up bodies in the parking lot.
“Some of them were still hot and burned through the bags,” he said. “I saw a lot of that. That was a rough three days.”
When he returned home, he couldn’t sleep, dealt with anger issues, jumped at noises and spent hours on the living room floor crying with his dogs. He spent three weeks as an inpatient in a psychiatric ward, and then was transferred to the Fort Lee WTU. On his third day there, Sawyer was playing with his new unit patch when his platoon sergeant began yelling.
“I ended up with a sergeant first class in my face yelling at me for disrespecting the people who died for that patch,” Sawyer said. “He didn’t know me from Adam. He’s lucky that morning I was very heavily medicated.”
Andrea Sawyer said the platoon sergeant made her husband “write a five-page paper on the importance of the patch.”
“Loyd went back to the psychiatric ward because he couldn’t deal with the people at the WTU,” she said. “That was his third day at the WTU.”
He was supposed to see his nurse case manager weekly, but didn’t. “They billed me for appointments when I wasn’t even there, just to pad the books,” he said. “They had me down one day for an 8 a.m. appointment at Portsmouth, a 9:30 a.m. appointment at Fort Lee and a 10 a.m. back at Portsmouth.”
He said it took three months after he received a referral to get an orthopedics appointment. “The only thing you get is what you fight tooth and nail for. They want you to give up so they can just process you out or wait for you to screw up so they can get you gone immediately.”
When an inspector general visit was scheduled, soldiers spent five hours cleaning their rooms, Sawyer said. “God knows they’re not allowed to say anything,” he said of soldiers in the WTU.
He said the soldiers were told to speak only if asked questions. If they spoke up on their own, the “retribution is s— duty,” he said.
Spc. Elizabeth Sartain had PTSD after serving as a mortuary affairs specialist in Kuwait. “Anyone who dies in Iraq, those bodies come through Kuwait,” she said.
When she got home, she tried to commit suicide. She poured pots of boiling oil over her arms and legs to try to match what she felt inside with what she felt outside.
“I was devastated,” she said. “I wasn’t getting the help I needed.”
After spending time as an inpatient at a psychiatric ward, she transferred to the WTU. She immediately began working eight hours a day as Payne’s orderly room clerk.
“It was overwhelming,” she said. “It was too hard to recover and be his secretary.”
She said she wasn’t allowed to make her own appointments, but did anyway because she needed help. “The case manager says she’ll call you back, but never does,” she said. “Weeks would go by. I’d check in, and it hadn’t been done. They’ve told us they’re overwhelmed.”
She said she also was berated for jumping the chain of command — for talking to the WTU ombudsman.
Ultimately, she received a disability rating of 50 percent for PTSD and was discharged.
Pvt. Aaron Howard began his tour at the WTU as a sergeant. In Iraq, he had his big toe shot off by another soldier who reacted poorly when an Iraqi family didn’t stop at a checkpoint. He also suffers from PTSD.
Before his injury, he had hoped to start law school and become an officer. But at the WTU, he said he was demoted for missing too many formations.
He said he received one Article 15 while he was waiting for results of a study that showed he has sleep apnea, narcolepsy and hypersombulance (excessive daytime sleepiness).
He received another Article 15 when he missed an appointment because he got the time wrong. He said his chain of command told him he “made up” his ailments.
“I’m getting counseling statements every 15 minutes,” he said. “I made E-5 in six years, no troubles. I come to Fort Lee and I’m the biggest turd in the Army.”
Recently, he said he was told he could get out administratively on a psychiatric discharge. That would end his time in the WTU — but he would leave with no medical benefits or retirement pay. He said his chain of command also tried to get him out for “continued misconduct.”
Ludwick said her biggest surprise came when she arrived at the WTU as a patient and was assigned duty as the unit’s executive officer. She was injured in February 2007 during a land navigation course when she fell down a hill in full battle rattle. She said she was told to “suck it up — you’re an officer.”
She did — and received her commission — but “there were days when I could barely walk,” she said.
Still, she continued her training, going to Fort Sill, Okla., for her officer leadership course. In her first week, she reinjured herself in combatives training.
“The other person yanked my leg up over her shoulder,” Ludwick explained. “She dropped me because she could hear it rip.”
Ludwick ended up in a leg immobilizer, and the second part of her training was waived. She went to Fort Lee for her officer basic course, but no one cut her formal orders for that. When she arrived in December 2007, she received orders attaching her as the WTU’s executive officer.
“They said, ‘We’re going to make you the XO,’” she said. “I can’t even walk. The cadre were like, ‘You need to be a patient.’”
So instead of performing XO duties, she worked at the post museum, leaving the XO slot empty. She remained in the museum position until October.
The first time she saw an orthopedic specialist since her injuries was at Fort Lee. “The surgeon at Portsmouth wouldn’t help me because it had been too long since the injury,” she said.
She discovered she had three herniated discs, a torn muscle in her back, stress fractures and nerve damage on one side of her body, and a broken ankle.
When it came time to do her paperwork for her medical retirement, only the herniated disc was put on it, even though she was using a wheelchair.
Her disability rating came back at 20 percent.
“It was a total joke,” she said. “They said, ‘Here’s $8,000 in severance pay — good luck.’”
She filed an IG complaint, which declared that everything had been done properly, she said.
Then she sent a letter to her congressman, after which she said she was told she could no longer talk with her Physical Evaluation Board liaison officer.
“They told me I was causing trouble,” she said.
Ludwick said she sank into depression and stayed away from the unit. She sought outside mental health help to deal with the panic attacks she said were caused by the people at the WTU.
She also talked to the Military Officer Association of America, who recommended that Parker look at her case. With his help, she appealed her case and ended up with a disability rating of 50 percent.
“My case is horrible, but when people come into the WTU, they’re all horrible,” she said. “I’m sure people are busy, but that’s the whole reason this unit was put in place. I’ve never been so much as asked if I need anything.”
Ludwick said she often sees people sign their paperwork without appealing it — or without understanding that they need to because their cases were handled improperly.
“People just get so frustrated,” Ludwick said. “They just sign and get out. I don’t have the luxury to just go out and get a job — I can barely walk.”
‘We’re at 100 percent’
Diamond said she has an open-door policy, but has had only three soldiers come through that door in the past few months.
She receives weekly updates from commanders and the ombudsman, and her office is in the clinic where soldiers go for appointments.
Diamond insisted staffing is not an issue. “We’re at 100 percent,” she said, adding that the unit has four case managers, though one is out on maternity leave.
“In the beginning, I think everyone was having problems,” she said. “I think we were overwhelmed. That should not be an issue so much today.”
She said the command keeps a timeline noting when appointments have been activated, and she hasn’t seen any problems with the timeline.
Diamond seemed unclear on some of the WTU’s policies.
“We have not used patients to oversee other patients,” she said, adding that privacy laws would prevent that. “They’ve got their own medical care to see to — that’s kind of a conflict.”
But Payne said some patients are given “leadership roles.”
“I expect them to lead,” he said.
Army WTU regulations state that patients will not be placed in roles overseeing other soldiers, but Payne said he ensures the wounded soldiers who fill squad leader positions do not write counseling statements or conduct UCMJ actions, and they are not rated for those duties. But he said only three noncommissioned officers were willing to perform those duties without being rated — two as team leaders and one as a squad leader.
“We’re not going to push them to do that,” Payne said.
When Craig was asked to fill such a role, he declined. “As an NCO, you’re supposed to know where your soldiers are at,” he said. “When the cadre’s gone, the team leader becomes a squad leader. There is nothing I can do for a wounded soldier for support. What are we actually going to do as patients for other patients?”
During the day, the soldiers are expected to attend 6:30 a.m. formations, work four hours minimum, and then attend a 1 p.m. formation. They may miss work for appointments, and Payne said supervisors know what medications they’re on.
But Craig said the rules can and do change, and they’re not always clear. As of mid-October, he said he was told his four-hour day has been switched to an eight-hour day, to be used for warrior tasks and drills.
“If I wanted to go do battle drills and reinjure myself, I’d go back to my old unit,” he said.
But the rules sometimes do differ from soldier to soldier. For example, while most have to appear for formation every day, some don’t. Staff Sgt. Jimmie Fedrick, one of the soldiers Payne offered for an interview to Military Times, was injured in Baghdad July 29, 2007, by a roadside bomb. It ripped apart 75 percent of his muscle in his back and leg, and he was diagnosed with a traumatic brain injury.
“I’m always in pain,” he said. “I’m always depressed. Always. I don’t come in that often. When I call here, there’s always someone to help.”
No one forces him to attend the 6:30 a.m. formations, and he said cadre and commander are willing to spend time with him when he needs it. “If I don’t come in, they call to ask if I’m OK.”
When Payne and Diamond were asked if Fort Lee should have a WTU, both paused for a long time.
“It’s served its purpose, given the mission that it had,” Diamond finally said. “I think the overall sense is that we’re doing a good job. I think there’s always going to be some conflicts, and if it doesn’t come up the chain, it’s hard to address.”
Cheek said the WTU situation has improved across the Army, and compared the WTU barracks to the “best hotels.”
However, he also said it’s “very likely” that some of the smaller WTUs will be consolidated. He said the biggest complaint for soldiers is the amount of time and bureaucracy they still must endure to get through the process, but that those delays “are really in the best interest of the soldier.”
“It’s not perfect,” he said, but added: “I have great confidence that we take good care of our soldiers.”