U.S. Senator Evan Bayh - Serving the People of Indiana
August 4, 2008

Bayh, Obama Seek to Broaden Treatment for Signature Injury of Iraq, Afghanistan Wars

Senators ask Secretary Gates to ensure soldiers with traumatic brain injuries have access to proven therapy

Washington—With an estimated 320,000 American soldiers who have been deployed to Iraq and Afghanistan experiencing a possible traumatic brain injury (TBI), Senators Evan Bayh (D-IN) and Barack Obama (D-IL) today called on Defense Secretary Robert Gates to extend military health care coverage to include proven treatment for the signature injury of the two wars.

“We are concerned that at a time when TBI is recognized as the signature wound of the conflicts in Iraq and Afghanistan, one of the most widely accepted and critical rehabilitative treatments for this injury, known as cognitive rehabilitation therapy, is excluded by the military’s TRICARE health insurance program,” the senators wrote to Gates today.

Traumatic brain injuries can include those caused by shrapnel that penetrate the skull, but also injuries with no visible signs caused by shockwaves from improvised explosive devices and mortars. Soldiers with TBI frequently have difficulties with attention, concentration, memory, problem-solving, and decision-making. Cognitive rehabilitation therapies help service members regain brain function.

“Given the prevalence of TBI among returning service personnel, it is difficult to comprehend why the military’s managed healthcare plan does not cover the very therapies that give our soldiers the best opportunities to recover and live full and productive lives,” the senators wrote.

Cognitive rehabilitation therapy was cited as key to the recovery of ABC News journalist Bob Woodruff, who was injured by a roadside bomb in January 2006 while reporting from Iraq. Woodruff has since started a foundation to increase wounded soldiers’ access to cognitive rehabilitation services.

“His remarkable recovery from a severe TBI has been widely cited as a powerful example of the great innovations of our military healthcare system,” the senators wrote. “Yet the treatment made available to Mr. Woodruff may be denied to U.S. military personnel who are similarly afflicted.”

Timely treatment is vital to the recovery process, but bureaucratic red tape and a system designed to handle body trauma and aging veterans has made it difficult for soldiers with TBI to obtain the specialized care they need to recover. In the letter, the senators noted that extending TRICARE coverage is especially important for the most gravely wounded combat veterans, including 19,922 soldiers who were “medically retired” by the military last year alone.

“Wounded warriors need and deserve unfettered access to this vital treatment,” said Laura A. Schiebelhut of the Brain Injury Association of America.

“Since brain injuries compromise physical, emotional, and cognitive abilities, it is unethical not to treat all three domains,” said Ron Ruff of the National Academy of Neuropsychology. “The human intellect is our most precious resource. Once the brain is injured, we should spare no resources to facilitate the brain’s cognitive recovery.”

“With great numbers of soldiers returning home with brain injuries we must provide a full continuum of care,” said Katie Sendak of the Wounded Warrior Project. “This step would do just that.”

Bayh has led efforts in the Senate to increase access to care for soldiers with TBI. Last year, Indiana National Guardsman Gerald Cassidy returned from Iraq and tried unsuccessfully for five months to get transferred to a private facility in Indianapolis specializing in the treatment of TBI. Cassidy died at a military transition center at Fort Knox waiting to be transferred.

“The best way we can honor the life of Sgt. Gerald Cassidy is by taking steps to ensure that we never again fail our heroes returning home from battle,” Senator Bayh said. “No soldiers who have been wounded in service for this country should have their care compromised or delayed when they return home. We cannot bring Sgt. Cassidy back, but we can honor his sacrifice by resolving to do better by our men and women in uniform.”

“With hundreds of thousands of service members returning home from Iraq and Afghanistan suffering from traumatic brain injuries, we must ensure these heroes have access to the best care and treatment available,” Senator Obama said. “These combat-related injuries require immediate and regular rehabilitation in order to help these service members live independent and healthy lives. It’s deeply concerning that one of the most accepted treatments for TBI, cognitive rehabilitation therapy, is not covered under the military’s health insurance program. I call on Secretary Gates to immediately address this alarming lack of coverage and provide our service members with the care they deserve.”

Other signatories on the Gates letter include Jeff Bingaman (D-NM), Hillary Clinton (D-NY), Ted Kennedy (D-MA), John Kerry (D-MA), Joe Lieberman (I-CT), Blanche Lincoln (D-AR), Claire McCaskill (D-MO) and Ken Salazar (D-CO).

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