Bush unveils plan for wounded troops

WASHINGTON —  Calling the nation’s system of caring for wounded troops an antiquated, bureaucratic nightmare, President Bush on Tuesday announced an overhaul intended to streamline procedures and provide new support for families.

The plan would change the way injured military personnel are evaluated and compensated: Those whose injuries prevent them from returning to active duty would be assigned pensions, and responsibility for their care would be quickly shifted from the Pentagon to the Department of Veterans Affairs.

It would also put a new emphasis on the diagnosis and treatment of post-traumatic stress disorder. Anyone entering a VA hospital for care would be evaluated for the disorder without having to request it.

The president’s announcement follows the recommendations of a bipartisan commission, which concluded in July that the treatment system for wounded soldiers, sailors, airmen and Marines needed “fundamental change.”

Some of the plan’s elements require congressional approval; other parts will be directly implemented by the administration.

Bush created the commission in March after a series of media reports drew attention to substandard care at Walter Reed Army Medical Center in Washington and to the bureaucratic difficulties wounded troops and their families faced in obtaining long-term care, financial assistance and other support.

The panel called on the president to create a system that would develop detailed individualized recovery plans for each injured service member.

The disclosures by the Washington Post last spring became an embarrassment for the administration, particularly as the White House was seeking political support for increasing the numbers of U.S. forces in Iraq.

By July, the commission, led by former Sen. Bob Dole (R-Kan.) and Donna Shalala, secretary of Health and Human Services during the Clinton administration, proposed potentially far-reaching changes in a system established more than 50 years ago to meet the needs of veterans of World War II and the Korean conflict.

“It’s an old system, it’s an antiquated system, it’s an outdated system that needs to be changed,” Bush said during a session with reporters in the White House Rose Garden after he met with the commission.

He praised the care provided at Walter Reed but said “serious problems” had caused “bureaucratic delays and administrative failures.”

He said the need for legislative action was “urgent.”

Dole agreed, describing the regulations of the current system as 600 pages of “Band-Aids and amendments.” The military personnel needing care now, he said, are of “a different generation than my generation, than the Vietnam generation. And the treatments are different.”

When the commission issued its report, Shalala estimated that its recommendations would cost $1 billion over 10 years.

Karl Zinsmeister, assistant to the president for domestic policy, said that before costs could be assessed, officials would have to redraw what is known as the injury schedule -- the amount that service members receive for permanent wounds, such as below-the-knee leg amputation.

In a conference call with reporters, Zinsmeister said the current military disability system, which covers 3 million wounded veterans, cost the government about $30 billion a year. The new system, he said, would probably “cost a little more than the old system.”

The White House also said that the Veterans Affairs department would establish “recovery coordinator” positions -- patient advocates assigned to oversee the management of individual veterans’ care, help them handle paperwork and other requirements of the federal bureaucracy, and ease their transition to civilian life. Creation of such a position was a key recommendation of the commission.

In legislation being sent to Congress, the administration would replace Pentagon disability payments with pensions, beginning with Iraq and Afghanistan war veterans. Additional payments would be awarded to cover the losses of potential earnings and quality of life as a result of service-related injuries.

Veterans would be reassessed every three years, and the rating system would be adjusted to reflect “modern concepts of medicine and disability,” the White House said, describing the plan.

Bush said the new plan would move away from the current practice of wounded troops often undergoing two examinations -- by the Pentagon and by Veterans Affairs -- and filling out two sets of paperwork.

He also said he would ask Congress to pass legislation that would give parents and spouses “the opportunity to take up to six months of unpaid leave when their loved ones are seriously wounded in combat.”

Severely wounded service members would be eligible for up to 40 hours of weekly in-home assistance, easing the burden on their families, the president said.

james.gerstenzang@latimes.com