Army amputees struggle to return to duty (12/5/04)

Army amputees struggle to return to duty

CHUCK Bartles took heart when President Bush pinned a Purple Heart to his chest this year, lauding him for courage and determination despite grievous wounds.
Sgt. Bartles, then struggling to recover from having his right arm blown off in Iraq, felt even better when Bush walked out of the hospital ward and made a stirring speech.

Just because a soldier has lost a leg or an arm in combat, the president said, doesn't mean he's useless. "People are no longer forced out of the military," he declared to applause. "Today, if wounded service members want to remain in uniform and can do the job, the military tries to help them stay."

Sparkling words. Easy words. Inaccurate words.

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Swiveling behind a machine gun atop a Humvee, Bartles was wounded in October 2003 by a roadside bomb blast that killed a fellow soldier. A civil affairs specialist with a master's degree, fluency in Russian and a Bronze Star for heroism in battle, he's the kind of man the Army should want to keep. He sweated for months to qualify for duty. This summer, his Army doctors finally certified him fit. His commander wanted him back. It seemed a sure thing.

Jubilant, Bartles re-enlisted. The next day he got a form letter from the Army. "Your medical condition prevents satisfactory performance of duty," it said, announcing the verdict: "permanent disability."

Bartles, 26, is fighting that judg-

ment. But it's a solitary struggle against pain, frustration, complex regulations and policies, competing bureaucracies and faceless paper-stampers. "Nobody can give you a straight answer," he said. "It's kind of put me on edge."

His reserve unit, the 418th Civil Affairs Battalion of Belton, Mo., returns to Iraq in April. "I am going with them, no doubt about that," Bartles vows in a deep, South Dakota growl.

Today, everyone loves an amputee. They're objects of tearful, chest-swelling hero worship, fawned over by politicians and celebrated in cartoon strips. But when the spotlight fades, there's a harder reality.

Combat in Iraq and Afghanistan is producing a parade of soldiers, Marines and others -- about three a week -- who have suffered traumatic or surgical amputation of at least one limb. Many are driven by duty, professionalism or a burning devotion to their buddies to return to their jobs. New surgical techniques and high-tech artificial limbs have enabled surgeons, prosthetists and therapists at Walter Reed Army Medical Center, where most amputees are treated, to bring them to higher levels of functioning than ever before.

But the Army is torn between its profound emotional commitment to these fallen warriors and its cold mission of providing fit, tough soldiers for war. And like much of society, it has been biased against amputees and other disabled people, according to current officers and military amputees. Now, it is trying to throw off those preconceptions while treating soldiers fairly.

It is a battle. In a series of high-level meetings this fall, senior officers and federal officials were unable to write a clear new policy for helping amputees.

"It was like pushing a noodle uphill," said Lt. Gen. Franklin "Buster" Hagenbeck, the Army's deputy chief of staff for personnel.

In frustration, Hagenbeck, who commanded U.S. forces in Afghanistan in 2002,

pledged

to personally review the case of any military amputee who feels he has been treated unfairly. "The bottom line is, if we can keep them in and they want to stay in, they stay in," he said.

But it may not be so easy.

An amputee faces a two-step process to get back to duty. First, a medical evaluation board assesses how capable he is of resuming his duties. Later, a physical evaluation board decides if he has demonstrated he can perform his job. This is a colder calculation, made by a three-person team usually including a senior officer, a personnel specialist and a doctor.

The board's job "is not to assist the soldier in furthering his career," said Dennis E. Brower, legal adviser to the Physical Disability Agency, which operates the board. "All job requirements are listed in Army regulations. All soldiers' cases are adjudicated exactly the same.

"Emotional responses," Brower said, "are not appropriate."

It was this board that turned down Bartles' application for approval to return to his job, despite his doctors' and commanding officer's enthusiastic recommendations. While Bartles is appealing the decision, Army officials said they have no choice but to apply the existing regulations.

"We try to be consistent," said Brower, a former Army officer. "Say a severely burned individual comes to us and says, 'I am disfigured and can't run because my muscles are contracted, but I'd like to be a soldier, too, would you give me the same special treatment you are supposedly giving to the amputees?'

"We cannot be looking at people differently that one type of injury is more worthy than another."

Currently, a soldier missing a limb must be considered unfit for duty. Like the U.S. tax code, however, Army regulations contain a maze of loopholes, exemptions and waivers, each with arcane conditions governing things like current or future disability payments. It is all so dense that even officials who administer the rules say they are occasionally confused.

As a result, some amputees return to duty in some capacity. Others who may be less disabled are retired or caught in bureaucratic limbo. Still others simply give up in disgust.

Turned down three times by the Army bureaucracy, Staff Sgt. Dan Metzdorf got back on duty with the 82nd Airborne Division in September -- but only by accepting a permanent "not fit for duty" rating and then taking a waiver. It is unclear whether he can ever deploy on an overseas mission.

"I understand the Army is a fighting force, not handing out Girl Scout cookies," said Metzdorf, 27, who in January lost his right leg in a blast south of Baghdad that killed three of his buddies. "You gotta take a good hard look at yourself, be realistic about the job you're doing."

Staff Sgt. David R. Chatham, 34, won a Silver Star for continuing to command his Bradley Fighting Vehicle to protect pinned-down U.S. troops after a rocket-propelled grenade shredded his lower left leg near Fallujah a year ago.

He has been laboring to get back on duty ever since doctors amputated the limb. "The whole disability thing is a maze," he said. "Unless you get to the very end of the process, there's no way to know all the answers."

Chatham had not heard of Hagenbeck's promise to review all cases and was unaware of the Army's new Disabled Soldier Support System, a program that is supposed to act as a soldier's advocate. His goal is to stay on active duty, perhaps to teach combat infantry tactics, until he can retire with a pension in four years. Instead, he fears, he will be forcibly retired.

When a physical evaluation board saw Chatham, its task was only to judge whether he was fit to resume his job as a combat infantryman -- not whether he would make a good teacher in another Army job. He expects to hear its verdict in a few weeks. "You can't imagine how stressful it is knowing that your career, your ability to make a living for your family, is in jeopardy," he said.

And that's on top of the stress of injury, most often from a blast that drives shrapnel and debris deep into torn flesh and can cause concussion, loss of hearing and other injuries. Recuperation can mean months of repeated surgery to prepare stumps for artificial limbs; learning to eat, dress and walk takes months longer. Many suffer infected wounds and other setbacks.

As a result, most amputees eventually accept medical retirement, with free lifetime medical care along with an Army disability payment of perhaps 60 percent of base pay. For a sergeant with four years' service, that would be $1,194.66 a month.

The few who reject that course find the way ahead is steep. Typically, recuperating amputees live in a residence at Walter Reed, where they say there is little opportunity for the training to qualify for active duty. Even those allowed back to a home base usually are assigned to a holding company with no weapons or field gear and thus few chances to practice military skills.

"One time I thought I had arranged to go up to Fort Meade to use their rifle range," said Bartles, who was trying to pass his weapons qualification requirements. "The night before, they called and said I couldn't go, they said I was a liability." If something happened, "it would reflect poorly on them."

Special Forces Sgt. Andy McCaffrey, who lost his right hand and forearm to a grenade blast in Afghanistan, has taught himself to do pull-ups, fire his weapons and do combat jumps with his artificial arm. He has videotaped his performance in a bid to convince Army authorities he is fit for service.

"It's a lonely crusade," said McCaffrey, 32. "It took me over a year to get back on the rifle range. There's nobody to go to bat for you. People at the hospital encourage you to go for it, and some people in the Army encourage you, but when you leave the hospital you gotta prove yourself all over again.

"Nobody wants to be the one to say 'Yes.'"

David Wood (david.wood@newhouse

.com) ) writes for Newshouse News Service.