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Wednesday, July 26, 2006

MICHAUD REQUESTS INVESTIGATION OF VAs EFFORTS TO TREAT VETERANS WITH TRAUMATIC BRAIN INJURY

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CONGRESSMAN MICHAEL H. MICHAUD
RANKING DEMOCRATIC MEMBER
SUBCOMMITTEE ON HEALTH
COMMITTEE ON VETERANS' AFFAIRS
U.S. HOUSE OF REPRESENTATIVES

MICHAUD REQUESTS INVESTIGATION OF VAs EFFORTS TO TREAT VETERANS WITH TRAUMATIC BRAIN INJURY

WASHINGTON---Representative Michael Michaud (D-ME), the Ranking Democratic Member of the Health Subcommittee of the House Veterans' Affairs Committee, has asked the Government Accountability Office (GAO), Congress' investigative arm, to conduct a comprehensive study of the Department of Veterans Affairs' (VA) efforts to identify and treat veterans with mild traumatic brain injury (TBI).

"Many of our troops who survive the blasts from improvised explosives devices are at risk of brain damage. With thousands of our troops in Iraq and Afghanastan at risk of TBI, this injury may be the silent signature wound of this war," said Michaud.

Servicemembers who sustain a closed head injury may have a mild TBI, which may not be readily identified by medical professionals, veterans, or their families. Mild TBI symptoms, including slower or confused thinking, memory loss, and mood changes, may not be evident for months or years after the initial injury.

Michaud's request for the GAO study came after newspaper reports that researchers screening returning troops found that 10% suffered at least one minor brain injury during combat, which my go undiagnosed because troops have no visible wounds.

In addition, the congressionally created VA Committee on the Care of Severe Chronically Mentally III Veterans has identified that the VA needs to develop resources to identify and treat returning veterans who have brain damage. The Committee recommended significant initiatives to address the needs of veterans with TBI.

VAs Inspector General recently issued a report that gave the VA mixed reviews for its treatment of severely and moderately brain-injured veterans. VAs case management of veterans care and support for families dealing with a brain-injured veteran were inconsistent.

Michaud's request asks the GAO to determine how the VA ensures that veterans who have experienced a mild TBI are identified and treated when they seek care at VA medical facilities, how the VA provides the needed education and support for families caring for veterans with TBI, and the obstacles to identifying veterans with mild TBI.

[GAO letter text shown below]


July 25, 2006

The Honorable David M. Walker
Comptroller General of the United States
Government Accountability Office
441 G Street, NW
Washington, D.C. 20548

Dear Mr. Walker:

Fatal casualties in Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) from blast-related injuries are lower than in previous conflicts due to improvements in protective combat equipment and advances in the delivery of medicine on the battlefield. From March 2003 through September 2005, two-thirds of all wounded-in-action evacuations from Operation Iraqi Freedom were for injuries due to explosions. Blast-injured servicemembers are at significant risk for a traumatic brain injury (TBI), which may result in long-term symptoms including, altered cognition, personality, and behavior, as well as sensory and motor impairments.

Many servicemembers, who sustain a closed head injury, may have a mild TBI that may not be as readily identified. If left untreated mild TBI can adversely impact basic activities of daily living, social integration, and employment, although early identification and threatment often results in full recovery. The symptoms of mild TBI---memory loss, depression, inability to concentrate and increased anxiety---are often mistaken for mental health concerns, such as post-traumatic stress disorder. Furthermore, symptoms resulting from mild brain injuries may not become evident for weeks, months, or years after the initial exposure. While servicemembers with moderate to severe injuries are often recognized and transferred for treatment, those with mild injuries may be returned to duty immediately or shortly after sustaining their injuries. As a result, many servicemembers with mild TBI might experience a delay in identification and treatment. This could have significant effects on them later in life and on VAs patient workload as servicemembers transition from military back to civilian life. In addition, the emotional difficulties and behavioral changes associated with TBI can put families in crisis.

Because of the potential implications for VA health care, veterans and their families, I am requesting that GAO identify:

* How the Department of Veterans Affairs (VA) ensures that veterans who have experienced a mild TBI are identified and treated when they seek care at VA medical facilities;

* How the VA provides the needed education and support for families caring for veterans with TBI;

* The obstacles to identifying veterans with mild TBI.

If you have any questions regarding this request, please contact Linda Bennett of the House Committee on Veteran's Affairs, at (202) 225-9756.

Sincerely,

MICHAEL H. MICHAUD
Ranking Democratic Member
Subcommittee on Health

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