December 4, 2021

News

News Network

Military Personnel: Army Needs to Better Enforce Requirements and Improve Record Keeping for Soldiers Whose Medical Conditions May Call for Significant Duty Limitations

24 min read
<div>The increasing need for warfighters for the Global War on Terrorism has meant longer and multiple deployments for soldiers. Medical readiness is essential to their performing needed duties, and an impairment that limits a soldier's capacities represents risk to the soldier, the unit, and the mission. Asked to review the Army's compliance with its guidance, GAO examined the extent to which the Army is (1) adhering to its medical and deployment requirements regarding decisions to send soldiers with medical conditions to Iraq and Afghanistan, and (2) deploying soldiers with medical conditions requiring duty limitations, and assigning them to duties suitable for their limitations. GAO reviewed Army guidance, and medical records for those preparing to deploy between April 2006 and March 2007; interviewed Army officials and commanders at Forts Benning, Stewart, and Drum, selected for their high deployment rates; and surveyed deployed soldiers with medical limitations.Army guidance allows commanders to deploy soldiers with medical conditions requiring duty limitations, subject to certain requirements, but the Army lacks enforcement mechanisms to ensure that all requirements are met, and medical record keeping problems obstruct the Army's visibility over these soldiers' conditions. A soldier diagnosed with an impairment must be given a physical profile form designating numerically the severity of the condition and, if designated 3 or higher (more severe), must be evaluated by a medical board. Commanders must then determine proper duty assignments based on soldiers' profile and commanders' staffing needs. From a random projectable sample, GAO estimates that 3 percent of soldiers from Forts Benning, Stewart, and Drum who had designations of 3 did not receive required board evaluations prior to being deployed to Iraq or Afghanistan for the period studied. In some cases, soldiers were not evaluated because commanders lacked timely access to profiles; in other cases, commanders did not take timely actions. The Army also had problems with retention and completeness of profiles; although guidance requires that approved profiles be retained in soldiers' medical records, 213 profiles were missing from the sample of 685 records reviewed. The Army was not consistent in assigning numerical designations reflecting soldiers' abilities to perform functional activities. GAO estimates from a random projectable sample that 7 percent of soldiers from these three installations had profiles indicating their inability to perform certain functional activities, yet carrying numerical designators below 3. While medical providers can "upgrade" numerical designations discretionarily based on knowledge of soldiers' conditions, the upgrades can mask limitations and cause commanders to deploy soldiers without needed board evaluations. While GAO found no evidence of widespread revision in profile designations, some soldiers interviewed or surveyed disagreed with their designations yet were reluctant to express concerns for fear of prejudicial treatment. The Army has instituted a program to provide ombudsmen to whom soldiers can bring medical concerns, but it is targeted at returning soldiers and is not well publicized as a resource for all soldiers with medical conditions. Without timely board evaluations and retention of profile information for deploying soldiers with medical conditions, the Army lacks full visibility and commanders must make medical readiness, deployment, and duty assignment decisions without being fully informed of soldiers' medical limitations. GAO estimates that about 10 percent of soldiers with medical conditions that could require duty limitations were deployed from the three installations, but survey response was too limited to enable GAO to project the extent to which they were assigned to suitable duties. Along with interviews, however, responses suggest that both soldiers and commanders believe soldiers are generally assigned to duties that accommodate their medical conditions. Occasional exceptions have occurred when a profile did not reflect all necessary medical information or a soldier's special skill was difficult to replace. Officials said soldiers sometimes understate their conditions to be deployed with their units, or overstate them to avoid deployment.</div>

The increasing need for warfighters for the Global War on Terrorism has meant longer and multiple deployments for soldiers. Medical readiness is essential to their performing needed duties, and an impairment that limits a soldier’s capacities represents risk to the soldier, the unit, and the mission. Asked to review the Army’s compliance with its guidance, GAO examined the extent to which the Army is (1) adhering to its medical and deployment requirements regarding decisions to send soldiers with medical conditions to Iraq and Afghanistan, and (2) deploying soldiers with medical conditions requiring duty limitations, and assigning them to duties suitable for their limitations. GAO reviewed Army guidance, and medical records for those preparing to deploy between April 2006 and March 2007; interviewed Army officials and commanders at Forts Benning, Stewart, and Drum, selected for their high deployment rates; and surveyed deployed soldiers with medical limitations.

Army guidance allows commanders to deploy soldiers with medical conditions requiring duty limitations, subject to certain requirements, but the Army lacks enforcement mechanisms to ensure that all requirements are met, and medical record keeping problems obstruct the Army’s visibility over these soldiers’ conditions. A soldier diagnosed with an impairment must be given a physical profile form designating numerically the severity of the condition and, if designated 3 or higher (more severe), must be evaluated by a medical board. Commanders must then determine proper duty assignments based on soldiers’ profile and commanders’ staffing needs. From a random projectable sample, GAO estimates that 3 percent of soldiers from Forts Benning, Stewart, and Drum who had designations of 3 did not receive required board evaluations prior to being deployed to Iraq or Afghanistan for the period studied. In some cases, soldiers were not evaluated because commanders lacked timely access to profiles; in other cases, commanders did not take timely actions. The Army also had problems with retention and completeness of profiles; although guidance requires that approved profiles be retained in soldiers’ medical records, 213 profiles were missing from the sample of 685 records reviewed. The Army was not consistent in assigning numerical designations reflecting soldiers’ abilities to perform functional activities. GAO estimates from a random projectable sample that 7 percent of soldiers from these three installations had profiles indicating their inability to perform certain functional activities, yet carrying numerical designators below 3. While medical providers can “upgrade” numerical designations discretionarily based on knowledge of soldiers’ conditions, the upgrades can mask limitations and cause commanders to deploy soldiers without needed board evaluations. While GAO found no evidence of widespread revision in profile designations, some soldiers interviewed or surveyed disagreed with their designations yet were reluctant to express concerns for fear of prejudicial treatment. The Army has instituted a program to provide ombudsmen to whom soldiers can bring medical concerns, but it is targeted at returning soldiers and is not well publicized as a resource for all soldiers with medical conditions. Without timely board evaluations and retention of profile information for deploying soldiers with medical conditions, the Army lacks full visibility and commanders must make medical readiness, deployment, and duty assignment decisions without being fully informed of soldiers’ medical limitations. GAO estimates that about 10 percent of soldiers with medical conditions that could require duty limitations were deployed from the three installations, but survey response was too limited to enable GAO to project the extent to which they were assigned to suitable duties. Along with interviews, however, responses suggest that both soldiers and commanders believe soldiers are generally assigned to duties that accommodate their medical conditions. Occasional exceptions have occurred when a profile did not reflect all necessary medical information or a soldier’s special skill was difficult to replace. Officials said soldiers sometimes understate their conditions to be deployed with their units, or overstate them to avoid deployment.

More from:

News Network

  • Florida Residents Charged with Conspiring to Violate Iran Sanctions, Other Crimes
    In Crime News
    Three Florida residents have been charged in federal district court in Miami with crimes related to their alleged violations of U.S. sanctions on Iran, and money laundering.
    [Read More…]
  • Romania Travel Advisory
    In Travel
    Reconsider travel to [Read More…]
  • Secretary Antony J. Blinken Introductory Remarks for President Biden and Vice President Harris’s Meeting with State Department Employees
    In Crime Control and Security News
    Antony J. Blinken, [Read More…]
  • Former Construction Executive Sentenced to 38 Months in Prison
    In Crime News
    A former senior New York construction official was sentenced to 38 months in prison today for tax evasion, announced Principal Deputy Assistant Attorney General Richard E. Zuckerman of the Justice Department’s Tax Division.
    [Read More…]
  • Priority Open Recommendations: Board of Governors of the Federal Reserve System
    In U.S GAO News
    What GAO Found In April 2020, GAO identified eight priority recommendations for the Federal Reserve. Since then, the Federal Reserve has implemented five of those recommendations. As of April 2021, the remaining open three priority recommendations for the Federal Reserve involve the following areas: Collaborating with other financial regulators to communicate with banks that have third-party relationships with fintech lenders about using alternative data in underwriting. Communicating uncertainties surrounding stress testing, including capital ratio estimates. Communicating uncertainties surrounding stress testing, including tolerance levels for key risks, and the degree of uncertainty in projected estimates. The Federal Reserve's continued attention to these issues could improve its ability to more effectively oversee risks to consumers and the safety and soundness of the U.S. banking system. Why GAO Did This Study Priority open recommendations are GAO recommendations that warrant priority attention from heads of key departments or agencies because their implementation could save large amounts of money; improve congressional or executive branch decision-making on major issues; eliminate mismanagement, fraud, and abuse; or ensure that programs comply with laws and funds are legally spent, among other benefits. Since 2015 GAO has sent letters to selected agencies to highlight the importance of implementing such recommendations. For more information, contact Daniel Garcia-Diaz at (202) 512-8678 or garciadiazd@gao.gov.
    [Read More…]
  • U.S. Reinforces Commitment to Secure, Stable, Democratic, and Self-Reliant Afghanistan at 2020 Conference
    In Crime Control and Security News
    Office of the [Read More…]
  • Justice Department and Federal Trade Commission Announce Agenda for Dec. 6 and 7 Workshop ‘Making Competition Work: Promoting Competition in Labor Markets’
    In Crime News
    The Department of Justice Antitrust Division and the Federal Trade Commission (FTC) announced an agenda for their upcoming virtual workshop regarding competition in labor markets.
    [Read More…]
  • Man Convicted of Receiving, Soliciting, and Promoting Child Pornography
    In Crime News
    A federal jury convicted a Virginia man today for downloading images and videos depicting children as young as four years old being sexually abused and for utilizing the Darknet to solicit and promote child pornography.
    [Read More…]
  • Former Army Green Beret Sentenced for Russian Espionage Conspiracy
    In Crime News
    A Virginia man and former Army Green Beret was sentenced today to XX years in prison for conspiring with Russian intelligence operatives to provide them with U.S. national defense information.
    [Read More…]
  • Man Pleads Guilty to Violating Endangered Species Act
    In Crime News
    A New York man pleaded guilty in U.S. District Court to selling a mounted leopard, which is an endangered species.
    [Read More…]
  • The United States Welcomes the Breakthrough To Restore Gulf and Arab Unity
    In Crime Control and Security News
    Michael R. Pompeo, [Read More…]
  • Guinea-Bissau Travel Advisory
    In Travel
    Reconsider travel to [Read More…]
  • Prescription Drugs: Medicare Spending on Drugs with Direct-to-Consumer Advertising
    In U.S GAO News
    What GAO Found Drug manufacturers spent $17.8 billion on direct-to-consumer advertising (DTCA) for 553 drugs from 2016 through 2018, and spending was relatively stable at about $6 billion each year. Almost half of this spending was for three therapeutic categories of drugs that treat chronic medical conditions, such as arthritis, diabetes, and depression. GAO also found that nearly all DTCA spending was on brand-name drugs, with about two-thirds concentrated on 39 drugs, about half of which entered the market from 2014 through 2017. Medicare Parts B and D and beneficiaries spent $560 billion on drugs from 2016 through 2018, $324 billion of which was spent on advertised drugs. Of the 553 advertised drugs, GAO found Medicare Parts B and D spending for 104 and 463 drugs, respectively. Among the drugs with the highest Medicare spending, some also had the highest DTCA spending. Specifically, among the top 10 drugs with the highest Medicare Parts B or D expenditures, four were also among the top 10 drugs in advertising spending in 2018: Eliquis (blood thinner), Humira (arthritis), Keytruda (cancer), and Lyrica (diabetic pain). Medicare Spending on Advertised Drugs, 2016 - 2018 GAO's review of four advertised drugs found that drug manufacturers changed their DTCA spending during key events, such as increasing spending when a drug was approved to treat additional conditions or decreasing spending following the approval of generic versions. GAO also found that DTCA may have contributed to increases in Medicare beneficiary use and spending among four selected drugs from 2010 through 2018. However, other factors likely contributed to a drug's Medicare beneficiary use and spending, making it difficult to isolate the relationship between drug advertising, use and spending. For example, GAO's review of four selected drugs showed that increases in unit prices were a factor, while stakeholders GAO interviewed cited other contributing factors such as doctors' prescribing decisions and manufacturers' drug promotions directed to doctors. Why GAO Did This Study Drug manufacturers use advertising on television and in other media to promote the use of their drugs to consumers and to encourage them to visit their doctors for more information. From 2016 through 2018, the Medicare program and beneficiaries spent $560 billion on drugs, and spending is projected to increase with the use of newer, more expensive drugs and an increase in beneficiaries. GAO was asked to examine DTCA and Medicare spending on advertised drugs. This report examines (1) drug manufacturer spending on DTCA; (2) Medicare spending on advertised drugs; and (3) changes in DTCA spending and Medicare use and spending for selected drugs. GAO analyzed DTCA spending data from Nielsen Media, and Medicare Parts B and D Drug Spending Dashboard data, from 2016 through 2018 (the most recent available data at the time of GAO's analysis). GAO also analyzed DTCA spending and Medicare data for a non-generalizable selection of four advertised drugs over a longer period—from 2010 through 2018. The four drugs were selected to reflect differences in DTCA and Medicare spending, beneficiary use, and medical conditions treated. GAO also interviewed or obtained information from officials representing 14 stakeholder groups (including research, trade, and physician organizations; and drug manufacturers of the four selected drugs) about DTCA spending and drug use and spending. The Department of Health and Human Services provided technical comments on a draft of this report, which GAO incorporated as appropriate. For more information, contact John Dicken at (202) 512-7114 or dickenj@gao.gov.
    [Read More…]
  • Philadelphia Tax Preparer Pleads Guilty to False Returns
    In Crime News
    A Pennsylvania man pleaded guilty yesterday to assisting in the preparation of false federal tax returns.
    [Read More…]
  • State Department Terrorist Designation Reviews and Amendments
    In Crime Control and Security News
    Office of the [Read More…]
  • Justice Department Settles with Texas-Based Staffing Company to Resolve Immigration-Related Discrimination
    In Crime News
    The Department of Justice announced today that it reached a settlement with National Systems America, LP (National Systems), a Dallas, Texas-based staffing agency.  
    [Read More…]
  • Secretary Antony J. Blinken and Danish Foreign Minister Jeppe Kofod at a Joint Press Availability
    In Crime Control and Security News
    Antony J. Blinken, [Read More…]
  • Warfighter Support: DOD Needs to Improve Its Planning for Using Contractors to Support Future Military Operations
    In U.S GAO News
    Contractors provide a broad range of support to U.S. forces deployed to Afghanistan and Iraq, with the number of contractors at times exceeding the number of military personnel in each country. The Department of Defense (DOD) has acknowledged shortcomings in how the role of contractors was addressed in its planning for Iraq and Afghanistan. In its report accompanying the National Defense Authorization Act for Fiscal Year 2009, the Senate Armed Services Committee directed GAO to assess DOD's development of contract support plans. This report examines (1) what progress DOD has made in developing operational contract support annexes for its operation plans, (2) the extent to which contract requirements are included in other sections of operation plans, and (3) DOD's progress in establishing a long-term capability to include operational contract support requirements in operation plans. GAO reviewed DOD policies, selected operation plans and annexes, and interviewed officials at the combatant commands, the Joint Staff, and Office of the Secretary of Defense.Although DOD guidance has called for combatant commanders to include an operational contract support annex--Annex W--in their operation plans since February 2006, we found only four operation plans with Annex Ws have been approved and planners have drafted Annex Ws for an additional 30 plans. According to combatant command officials, most of the annexes drafted to date restated broad language from existing DOD guidance on the use of contractors to support deployed forces. Several factors help explain the difficulties planners face in identifying specific contract support requirements in Annex Ws. For example, most operation plans contained limited information on matters such as the size and capabilities of the military force involved, hindering the ability of planners to identify detailed contract support requirements. In addition, shortcomings in guidance on how and when to develop contract support annexes complicate DOD's efforts to consistently address contract requirements in operation plans and resulted in a mismatch in expectations between senior DOD leadership and combatant command planners regarding the degree to which Annex Ws will contain specific information on contract support requirements. Senior decision makers may incorrectly assume that operation plans have adequately addressed contractor requirements. As a result, they risk not fully understanding the extent to which the combatant command will be relying on contractors to support combat operations and being unprepared to provide the necessary management and oversight of deployed contractor personnel. According to combatant command officials, detailed information on operational contract support requirements is generally not included in other sections or annexes of the operation plans. Although DOD guidance underscores the importance of addressing contractor requirements throughout an operation plan, including the base plan and other annexes as appropriate, GAO found that nonlogistics personnel tend to assume that the logistics community will address the need to incorporate operational contract support throughout operation plans. For example, combatant command officials told GAO that they were not aware of any assumptions specifically addressing the potential use or role of operational contract support in their base plans. Similarly, according to DOD planners, there is a lack of details on contract support in other parts of most base plans or in the nonlogistics (e.g., communication or intelligence) annexes of operation plans. DOD has launched two initiatives to improve its capability to address operational contract support requirements in its operation plans, but these initiatives are being refined and their future is uncertain. DOD has placed joint operational contract support planners at each combatant command to assist with the drafting of Annex Ws. In addition, the department has created the Joint Contingency Acquisition Support Office to help ensure that contract support planning is consistent across the department. For both initiatives, a lack of institutionalization in guidance and funding and staffing uncertainties have created challenges in how they execute their responsibilities.
    [Read More…]
  • Observance of International Day of the Girl Child
    In Crime Control and Security News
    Antony J. Blinken, [Read More…]
  • Principal Deputy Assistant Attorney General Jonathan Brightbill Delivers Remarks at the 2020 Annual Pennsylvania Chamber Environmental Virtual Conference
    In Crime News
    I am happy to be back home in Pennsylvania — in a sense — and have the opportunity to speak with the Pennsylvania Chamber of Business and Industry. Since this organization’s founding in 1916, this Chamber has advocated for job creation and greater prosperity for all Pennsylvanians. It represents almost 50 percent of Pennsylvania’s private workforce with a membership of 10,000 businesses ranging from sole proprietors to Fortune 100 companies.
    [Read More…]

Crime

Network News © 2005 Area.Control.Network™ All rights reserved.