Report | Oct. 9, 2014

Assessment of DoD-Provided Healthcare for Members of the United States Armed Forces Reserve Components

DODIG-2015-002

Objective

The objectives of this assessment were to determine whether DoD-provided healthcare programs support pre-deployment medical readiness rates and the efficient and effective post-deployment care of Reserve Component (RC) service members. We examined DoD-provided healthcare programs used to maintain or improve required medical readiness rates and also examined DoD-provided healthcare programs for wounded, ill, and injured members of the RC.

This is a follow-on assessment to six previous Wounded Warrior assessment reports where we noted systemic issues with DoD-provided healthcare programs used by RC service members.

What We Found

We determined that RC service members, when eligible, had access to DoD-provided care to enable units to meet DoD-required individual medical readiness rates. We also determined that line of duty medical care was available to treat wounded, ill, and injured RC service members. However, we determined that delayed or denied access to line of duty care presented a risk, as outlined in this report.

Observations

This assessment identified several issues which, if addressed by DoD and the Military Services, will enhance the overall effectiveness of DoD-provided healthcare programs, help improve the RC’s medical readiness rates, and improve care and transition services for wounded, ill, and injured RC members not receiving care at military treatment facilities.

The observations included in this report:

  • Active Component (AC) service members transferred to the Reserve Component with medical conditions which limited their deployability or for which they were subsequently found to be non-deployable.
  • RC service members who filled deployable billets could not be officially separated (for medical reasons) from the RC when they were found fit-for-duty by a medical board, even though they had medically-related limiting conditions that made them not deployable or only deployable with certain waivers.
  • Army RC soldiers (not on active duty), who were issued temporary medical profiles, had limited access to DoD-provided healthcare to be medically evaluated in accordance with Army Regulation 40-501.
  • RC service members returned from deployments or temporary duty with missing or incomplete medical histories and line of duty documentation. As a result, deactivated RC service members had to reconstruct medical histories and line of duty documentation in order to receive DoD-provided medical care for wounds, illnesses, and injuries incurred or aggravated while deployed or assigned temporary duty.
  • Wounded, ill, and injured RC service members had difficulty accessing authorized medical services at military treatment facilities because different forms were used by each Service to prove line of duty medical entitlements.

Recommendations

We recommend the Under Secretary of Defense for Personnel and Readiness:

  • Establish guidance that requires all Active Component service members who transfer into the Selected Reserve meet Individual Medical Readiness requirements.
  • Develop and implement a plan that ensures Reserve Components’ service personnel authorizations allow units to retain service members in accordance with 10 U.S.C. §1214a while meeting unit deployment requirements.
  • Develop and implement a plan so that Army Reserve Component service members receive DoD-provided medical evaluations of temporary medical profiles in accordance with AR 40-501.
  • Establish policy that assigns responsibilities to Commanders and medical authorities to manage medical histories and line of duty documentation for deployed or temporary duty RC service members in a standardized manner across all Services, so that both are complete and available to their units in a timely manner.
  • Establish standardized DoD form(s) and procedures that provide access for all RC service members to line of duty care at all military treatment facilities.

Management Comments and Our Response

The Under Secretary of Defense for Personnel and Readiness provided all comments to this report. Management concurred with all recommendations. Based on management comments, we redirected Recommendations 1, 3, 4, and 5 to the office of Undersecretary of Defense for Personnel and Readiness.