Invisible wounds Archives

Bad-Paper

The Pentagon is helping some veterans with other-than-honorable discharges, also known as “bad paper” discharges, increased direction on obtaining a record review and upgrade.

Last month, the Department of Defense announced that it will direct the review boards for each service branch to consider a more liberal criteria to give veterans the opportunity to plead their cases and explain the extenuating circumstances of their discharge. This is especially beneficial for bad paper discharges received while suffering from traumatic brain injury or post-traumatic stress disorder as a result of military operations, sexual assault, or sexual harassment.

Veterans with bad paper discharges have long complained that they were drummed out of the service with no consideration of their invisible wounds.

According to Air Force Lt. Col. Reggie Yager, the acting director of legal policy in the Office of the Undersecretary of Defense for Personnel and Readiness, “Liberal consideration, in our view, is the right balance to ensure we are making fact-based decisions while also giving appropriate leeway to the challenges posed by these invisible wounds.”

A General Accountability Office report released earlier this year found that of nearly 92,000 service members discharged for misconduct between 2011 and 2015, nearly two-thirds were suffering from Traumatic Brain Injury or mental health issues such as PTSD, anxiety, bipolar or substance abuse disorders.

Vietnam-era veterans also had a large number of bad paper discharges for misconduct

Veterans seeking a discharge upgrade will need to provide evidence to support their claim.

Under the new DoD guidance, the reviewing authorities will need to ask:

Whether the veteran had a condition or experience that may excuse or mitigate the discharge;
If the condition existed or experience occurred during military service;
If the condition or experience excuses or mitigates the discharge; and
If the condition or experience outweighs the discharge.

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It has been estimated that approximately 20% of the 2.3 million troops who have served in combat since 2001 have suffered a brain injury and/or developed PTSD. Medical researchers are closing is on the creation of a test designed to detect post-traumatic stress or traumatic brain injury.

Currently, conditions such as PTSD and TBI are only diagnosed with self-reported symptoms and subjective exams. But scientists from five different institutions are getting closer to formulating a definitive test for these injuries. In a collaborative attempt to develop tests to detect the invisible wounds, NYU’s Langone Medical Center, the Steven and Alexandra Cohen Veterans Center for the Study of PTS and TBI, Stanford University, Emory University School of Medicine, and the Department of Defense are examining PTSD and TBI conditions in more than 4,000 service members and civilians.

Now, in year two of the five year, $42.9 million study to locate biomarkers that can indicate evidence of PTSD and TBI, the preliminary results have determined symptoms and methods that can be utilized to determine the presence of these conditions. Blood and genetic variation tests, brain imaging, eye movements and even vocal changes have been determined to provide evidence of PTSD and TBI.

Using brain imaging, researchers have found that patients with PTSD have above-average activity in the amygdala, the portion of the brain responsible for creating and storing memories. They also found below-average activity in the medial prefrontal cortex, the portion of the brain that controls social behavior and expression as a response to fear-inducing stimulus. These findings could lead to brain scan tests to diagnose PTSD and confirm treatments appropriate for the condition.

Other research has found that people with PTSD have distinct vocal patterns as part of the condition. The further study of the vocal patterns in PTSD patients could pave the way to a definitive examination to determine whether a person has the disorder.

For years, athletic trainers, emergency medical responders and military medics have looked into the eyes of patients believed to have suffered TBIs. Researchers in the study are also looking at out-of-sync eye movements to develop a quick test for concussion.

Researchers at the Cohen Veterans Center tracked the eye movements of more than 400 service members and Veterans as they watched a four-minute video. They found that these patients’ eyes did not track together in individuals who had or were recovering from a TBI. The condition is called an “anisocoric and disconjugate gaze.” Further study could lead to the development of a medical device that could be used in combat theaters to detect a TBI, such as a concussion, immediately after it occurs.

The next phase of the study will involve determining the most promising biomarkers, and how they can be used to personalize treatments for PTSD and TBI.

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