Bill proposes help for brain-injured war veterans
Martha Stoddard, Omaha World-Herald
Returning soldiers who need specialized treatment often find the military’s health insurance program won’t pay for it.
LINCOLN — State Sen. Tom White of Omaha figures it’s only a matter of time before a traumatic brain injury sends a Nebraskan home from the wars in Iraq or Afghanistan and straight into a bureaucratic wall.
That wall is the apparent refusal by TriCare, the military health insurance program, to cover cognitive rehabilitation services for injured veterans.
In response, White has turned to the Nebraska Legislature to help those veterans.
“My hope is you will correct what I believe is one of the more shameful oversights” of the federal government, White told the Legislature’s Health and Human Services Committee at a hearing Wednesday.
White introduced Legislative Bill 1169, which would create a state assistance program for brain-injured veterans who need help regaining mental and social skills.
The proposed program would provide coverage similar to what is allowed under state Medicaid.
Legislative fiscal staff estimated the rehabilitation could last an average of 120 days and cost as much as $70,440 per person at Quality Living, the only provider of such services in Nebraska.
Traumatic brain injury, or TBI, and post-traumatic stress disorder have been called the “signature injuries” of the Iraq war.
The combination of heavily protected vehicles and modern body armor means that soldiers can survive many intense explosions caused by improvised explosive devices, the weapon of choice for Iraqi insurgents.
But the shock waves from those explosions can cause whiplash, concussions and the long-term effects known as TBI.
Those who suffer more severe head injuries or encounter multiple explosions are more likely to deal with the symptoms of TBI — dizziness, memory loss, headaches and vision problems.
About 40 percent of combat soldiers in Iraq have suffered some form of head injury, Col. Jonathan Jaffin, former commander of the Army Medical Research and Materiel Command, said in an interview last year.
Post-traumatic stress disorder is a psychological disorder affecting some soldiers who have been injured in combat. It is not addressed by the White legislation.
Cognitive services are critical to helping brain-injured people recover to the fullest extent possible, said Susan Connors, president and chief executive officer of the Brain Injury Association of America, based in McLean, Va.
Insurers had been reluctant to cover cognitive rehabilitation because of the lack of research on its effects, Connors said. The treatment has since been proved effective, but many insurers still deny coverage.
Connors said the Brain Injury Association has been pushing for coverage of cognitive rehabilitation by TriCare and other insurers. She said she has heard mixed stories from families of injured veterans about whether TriCare covered cognitive rehabilitation.
David DiMartino, a spokesman for U.S. Sen. Ben Nelson, D-Neb., said he has been told the care is covered.
However, Matt Clough, vice president of Quality Living of Omaha, said both the TriCare policy manual and a letter from TriCare manager Maj. Gen. Elder Granger specifically exclude cognitive rehabilitation from coverage.
At the national level, U.S. Sen. Chuck Hagel, R-Neb., has talked with Quality Living officials and is looking at ways to ensure that veterans get the care they need, said spokesman Jordan Stark.