Medical units pay price of lowered recruiting standards, reports say
By Carl Prine
Published: Sunday, February 6, 2011
WASHINGTON — Special Army medical units designed to heal wounded heroes today brim with criminals, drug addicts, malingerers and mentally and physically broken soldiers who brought their ailments to boot camp, according to internal Pentagon reports obtained by the Tribune-Review.
Compiled in 2009 and 2010 by the Pentagon’s Office of Wounded Warrior Care and Transition Policy in Alexandria, Va., the reports allege that the Army's 38 Warrior Transition units are clogged with soldiers who wouldn't have entered service had the Army not lowered recruiting standards during the wars in Iraq and Afghanistan.
The reports allege that slumping morale of combat soldiers in the special medical units had become "exponential," partly due to malingering malcontents and "barracks lawyers" who "game the system" by "camping for years" there to the point they eventually outnumber those hurt overseas.
"A lot of them are people who never should have been recruited in the first place," said former Deputy Undersecretary of Defense Noel Koch, who sent investigators out to canvass Warrior Transition units nationwide and in Europe. "There seems to be some willful blindness by some in the military, for careerism or whatever other reason, for not making the connection."
The White House's choice to fix the Department of Defense's special medical units, Koch said he was forced to resign last April after he brought these and other findings to Pentagon officials.
Officials declined to comment.
Koch's concerns cut to the heart of a debate about the all-volunteer force that has sustained the Army throughout the wars in Afghanistan and Iraq. To meet manpower goals, Koch suspects the Pentagon began cutting corners in 2004, when the insurgency in Iraq exploded and the Army was hit with a chronic recruiting slump.
Back then, the Army lowered recruiting standards and granted increasingly higher numbers of "moral" and medical waivers to enlistees who admitted drug abuse, criminality or health problems — conditions that formerly disqualified them from service.
In 2004, about 12 percent of recruits entering the Army were granted these special medical and legal waivers. By 2008, however, the number of waivers had more than doubled to nearly 26 percent, according to Army records.
In 2009, the Army drastically slashed the number of "moral" waivers, but still sent 18,000 recruits — about one out of every four enlistees — to boot camp with pre-existing medical problems, according to a recent report by the Army's Division of Preventive Medicine.
More than half of all recruits requesting waivers for hypertension, alcohol and cocaine abuse, personality disorders, head injuries, seizures, valvular heart disease, glaucoma and most other ailments successfully entered the Army. Overall, about 65 percent of all recruits seeking medical waivers between 2004 and 2010 were granted entry into the Army; 8,200 of these soldiers later were treated for neurotic or personality disorders, psychosis or substance addiction, according to the study.
Koch says he is convinced many of those soldiers who came in on special waivers to meet manpower goals ended up in the Army's Warrior Transition units. But that problem was compounded by soldiers going to boot camp with conditions that never were detected by Army medical screeners and recruiters.
In late 2009, Koch's team learned that nearly a third of those receiving medical discharges at Georgia's Fort Benning were recruits who couldn't make it out of boot camp.
Many recruits had "stopped taking medication to meet recruiting standards" and a "significant number" of the patients in the Army's Warrior Transition units were freighted with "pre-existing behavioral health or chronic health issues ... not reported during recruitment process," according to the internal reports.
When the Trib brought these findings to Lt. Gen. Thomas P. Bostick, the three-star general who oversaw Army recruiting between late 2005 and 2009, he said he was unaware of reports linking recruits with pre-existing conditions to the bloated medical barracks.
While Bostick defended his recruiters by saying federal privacy laws gagged them from grilling enlistees about potentially disqualifying mental health problems, he nevertheless insisted that recruiters "have the ability and the background and the experience to determine what's going on."
While it's easy for the Pentagon to count soldiers with pre-existing conditions getting discharged for the maladies years later, analysts have difficulty estimating the number of "malingerers" faking or exaggerating their conditions to shirk duty or gain Army and Department of Veterans Affairs benefits.
The Army takes malingering seriously. Feigning ailments or self-inflicting wounds to avoid duty or garner benefits are felonies that could trigger prison sentences of up to 10 years under the military's Uniform Code of Military Justice.
At Fort Riley in Kansas, home to the First Infantry Division, cadre squad leaders at the base's Warrior Transition unit estimated three malingerers to every one legitimately sick or injured soldier, according to the internal reports. At Fort Benning, however, staffers put the number closer to 10 percent.
Anne Champney, a former civilian ombudsman hired by the Army's Medical Command to safeguard the rights of patients at Joint Base Lewis-McChord south of Seattle, said "very, very few" malingerers were found there over the past two years, maybe "only a couple of soldiers."
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