Transition Chief: Troop Support Nothing Like Vietnam

Vietnam War veterans will nod with understanding over many of Noel Koch's comments contrasting support for wounded troops and veterans today, from citizenry and government, compared to how it was 40 years ago.

During the Vietnam War, he said, "we got very good at saving people's lives on the battlefield.  But we never got good at giving them a life worth living once they got back here," Koch said.  "We just warehoused them in VA hospitals and that's part of the scandal of the times."

"We're not going to let that happen again," he continued.  "And that's a directive that comes from the president -- and I should say the First Lady as well -- and runs in a straight line, with the secretary of defense straddling it, right into this office."

Koch is director of the Department of Defense's Office of Transition Policy and Care Coodination (TPCC), an entity less than a year old.  He's responsible for how well DoD and the services implement very ambitious initiatives and reforms to ensure this generation of warriors gets the support it needs to stay in service or move as smoothly as possible into civilian life.

At the risk of personalizing the issue too much, Koch said, he noted he's a member of Vietnam Veterans of America.

"And our basic motto is never again will one generation of veterans abandon another.  You may take from that a certain sense of grievance," he said, "but that's not the important part.  The important part is this: that [Vietnam] generation is determined to take care of this generation."

In the wake of the scandal that rocked the campus of the Walter Reed Medical Center more than two years ago, several commissions and internal studies produced mounds of recommendations to improve support of wounded warriors.  Seemingly before the ink dried on commission draft reports, Congress had passed comprehensive wounded warrior legislation.

Meanwhile, the departments of Defense and Veterans Affairs jointly established the Wounded, Ill and Injured Senior Oversight Committee (SOC), co-chaired by the deputy secretaries of VA and DoD.  The SOC was to ensure that wounded warrior legislation was implemented properly and that key task force recommendations were adopted and resourced.

The spotlight has dimmed, SOC survives but, within DoD, it's Koch's TPCC office, with a staff of 30 and rising, taking over day-to-day oversight of dramatic warrior transition reforms.  Here's a rundown from our interview with Koch (pronounced Cook) in his Alexandria, Va., office Tuesday:

-- Disability Evaluation System (DES) pilot.  Jointly administered by DoD and VA, the pilot now is running at 21 military hospitals.  It gives ill or injured service members a faster, more seamless disability review and rating process with results recognized by both departments.  The pilot will expand soon to seven more military treatment facilities, enough so that half of all service disablity evaluations will be done in the streamlined system.

Since November 2007, nearly 4000 members have enrolled in the pilot.  Through August this year, 534 members had completed the process.  Nearly half have been awarded disability retirement, the result of stricter adherence to more liberal VA rating rules and higher ratings for Post-Traumatic Stress Disorder.  Thirty-eight percent are returning to duty.  Only 13 percent, so far, have been separated, most with a lump sum severance.

Learn more about PTSD.

Under the legacy system, DoD and VA each conducted their own physicals and do their own ratings.  It takes an average 540 days to complete.  The pilot effectively cuts that time in half.  On average, the pilot is taking 273 days to complete, from enrollment until the member has a VA benefit decision in hand.  Koch said the pilot is popular with participants.

He suggested the process would be even faster except that now the focus is on the member: his or her sacrifice and his or her personal goals.

"We're not looking, in the very first instance, at moving these people into veterans' status.  We're looking at where we can continue them in service.  That is a pretty profound and encompassing procedure," Koch said.

Can they stay in their occupational specialty? If not, can they change skills and stay in their service?  If not, can they move to another service?

-- Recovery Care Coordinators.  The Army still calls them Wounded Warrior Advocates.  To Marines, they're members of the Wounded Warrior Regiment.  To Koch and his staff, they are Recovery Care Coordinators or RCCs, managing the non-medical care of war wounded until they recover or are separated or retired.  Often the contact doesn't stop then.  Marines, for example, try to maintain contact with all of their seriously wounded vets to ensure they're getting the support they deserve.

Koch's office is setting standards for RCCs and conducting training.

"We're in a very unique situation with these wars," Koch said.  "We're trying to take care of people in a way we never did before."

Koch's couldn't guess the number military and civilian personnel across the Defense Department now engaged in transition assistance efforts.   Army Chief of Staff, Gen. George W. Casey Jr., said recently that 10,000 soldiers are in, or running, warrior transition units.

"It's a new mindset," said Koch.  "Everybody's behind it.  It's really the first major test of the all-volunteer military, in a sense."

-- Physical Disability Board of Review.  Koch's shop oversees the PDBR.  Under a law passed two years ago, as many as 77,000 veterans separated since 9/11 with disability ratings of 0 to 20 percent are eligible to have ratings reconsidered and, perhaps, upgraded if their Physical Evaluation Board didn't use the more liberal VA rating schedule in effect at separation.  A rating of 30 percent or higher means disability retirement, rather than a lump-sum severance, and TRICARE eligibility for veteran and family.  [We'll write more next week on the PDBR, what it can and can't do for those who feel their original military rating was unfair.]

The DES pilot, the PDBR, the RCC, Koch said, all show "we're trying to do things differently."   

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