Warrior in Transition
Parent Unit Roles
Parent unit leadership must possess knowledge of the Warrior Transition Unit (WTU) process and what actually happens to the unit's Soldier during his transition. It is important for unit leaders to fully understand the criteria used by the WTU to accept a Warrior in Transition (WT) when beginning the process as well as the tools available to the WTU enabling it to provide WTs needed and well-deserved care.
Parent unit leadership is required to complete and provide the necessary information if a Soldier is wounded, ill, or injured and subsequently transferred to a medical treatment facility (MTF) or other healthcare provider. This documentation is vital for all medical providers working for the WTU. WTUs have identified that a large percentage of WTs do not have a line of duty (LOD) report or medical/dental records. Parent units must ensure that WTs transferred to WTUs possess complete sets of medical and dental records. The current mobilization order can affect the WT's pay when expired or due to expire soon after a WT's transfer to the WTU. Parent units must make every effort to change or extend orders for WTs to ensure there are no gaps in military pay.
The tasks and lessons learned presented in this chapter are the keys to success identified by the WT, his Family, and the WTU staffs interviewed and surveyed. However, they are not the only solutions, and these tasks and lessons represent only tasks that parent units may need to perform. While the WTU continues to develop and evolve and fine-tune the entire process, actual necessary tasks may change.
Mission priority over Soldier well-being. "As a company commander I didn't want to leave my troops, so I drove on after a head injury, which only resulted in a disability with TBI [traumatic brain injury]." -A Warrior in Transition
Deciding to refer a Soldier for medical treatment can be a difficult decision for a commander when his unit is deploying or in a combat environment. Nonetheless, leaders must be proactive and secure immediate care for their Soldiers. Poor and/or untimely decision making by unit leaders can yield devastating results for the Soldier and his Family and can result in long-term health problems, lengthy recovery periods, or temporary or permanent disability. There is no room in today's fast-paced, high-stress environment for the traditional Army "suck it up and drive on" attitude. Army leaders must eliminate the stigma traditionally shown toward Soldiers who indicate medical problems during ramp-up and deployment periods because data shows that neglect of real medical issues produces long-term, negative physical and/or behavioral outcomes for Soldiers. The Army's focus must be on the Soldier's current and future well-being and not on any potential problems faced in the short term due to a Soldier's temporary disability. Identifying a Soldier's medical requirements early on can considerably ease and facilitate rehabilitation and transition. This identification process results in increased rates of return of WTs to their parent units.
Community-based Warrior Transition Unit entry requirements. The community-based WTU (CBWTU) allows Soldiers to live and perform duties close to their homes and Families. Soldiers receive medical care in their community at Department of Defense, TRICARE, or Veteran's Affairs healthcare facilities rather than remaining at an installation MTF. The CBWTU primarily provides care and transition services for WTs from the reserve component that do not need the level of care and transition services provided by WTUs on installations.
Defense Enrollment Eligibility Reporting System. Soldiers often arrive at WTUs without current information in the Defense Enrollment Eligibility Reporting System (DEERS). This leaves the WTU without access to information necessary for in-processing the WT and completing other administrative tasks. Units must continually and accurately update DEERS information on all Soldiers during predeployment, deployment, and redeployment.
Line of duty report. "My unit was mobilizing when I was injured and didn't get the LOD filled out so now I have to wait on the documentation in order to go through the MEB [medical evaluation board], which is a big hassle." -A Warrior in Transition
Currently, the number one document that WTs and WTUs need, yet parent RC units consistently fail to provide is the LOD report contained on Department of the Army Form 2173, Statement of Medical Examination and Duty Status. Parent unit leadership must complete and provide the LOD report when a Soldier is wounded, ill, or injured and transferred to an MTF or healthcare provider. A copy of this form should also be sent to the unit's rear detachment. This documentation is vital for all medical providers and the WT. Without this form, medical authorities cannot complete the medical evaluation board (MEB) process, doctors may not obtain the WT's medical history, and benefits can be delayed or denied. The LOD report must be completed and signed by the Soldier's commander when the Soldier is wounded, ill, and/or injured. A nurse practitioner or physician assistant cannot sign the LOD report for the parent unit commander.
Equipment. "I was injured in Diyala Province and transported to Balad and then Kuwait where I waited for travel to LRMC [Landstuhl Regional Medical Center] when my leadership requested I return to Balad for my equipment because they could not send it. I needed help carrying the equipment, and my medical care was delayed." -A Warrior in Transition
The unit's logistics officer must account for a wounded, ill, or injured Soldier's equipment in the property book. Units must make sure they close out central issue facility records from theater for the wounded, ill, or injured Soldier. WTs remain responsible for their equipment while assigned to the WTU. Units must assume this aspect of the wounded, ill, or injured Soldier's property management responsibilities so that the Soldier is not left with that burden when discharged from the WTU. Parent units should contact the WTU as soon as possible to initiate the necessary coordination when records have not been closed out.
Medical records. "WTs arrive to the WTU without medical records, making it difficult for the NCM [nurse case manager] and PCM [primary care manager] to determine a medical history and complete the MEB process." -A Warrior Transition Unit
Unfortunately, many times the medical record does not accompany the Soldier to the WTU; WTUs need it to develop effective medical planning. The WT must have a copy of his medical record forwarded to the MTF. Historical medical information is beneficial for the WT when prior wounds, illnesses, or injuries require medical care or later for determining disability and other benefits. A parent unit must also ensure it sends all medical and dental records to the MTF and keep the WT's Medical Protection System (MEDPROS) status updated at all times. Note: MEDPROS is a medical readiness data system that includes medical and dental records that commands and medical leaders must update.
Confidentiality. Unit leadership must understand the WT's medical information is confidential. Knowing the importance of the Health Insurance Portability and Accountability Act of 1996 and the privacy rule can clarify why it is difficult to obtain medical information on Soldiers. When calling the WTU, leaders must contact the WT's assigned NCM for any medical information. The WTU NCM (or case manager [CM]) is the point of contact for all medical information regarding the WT and may only discuss information with unit representatives with the WT's signed consent.
Unit follow-up. "My unit forgot about me when I was assigned to the WTU, and I guess they don't care whether I get better or not." -A Warrior in Transition
Some parent unit leaders follow up with Soldiers after their transfer to a WTU; however, most parent units do not. It is important for parent unit leaders to continue ongoing communication throughout the WT's transition. During this transition phase, the Soldier feels as though he is no longer part of that unit. Occasional communication from the unit helps WTs feel they still belong to the units.
Warrior Transition Unit work mentorship program. "It is great to be able to contribute my skills with a job while I recover." -A Warrior in Transition
The WTU work mentorship program provides the WT the opportunity to remain active with his or her parent unit. Parent unit leadership can provide the WT a job in his MOS or a working environment during the transition while in the WTU. Units must coordinate and communicate with the WT's CM, PCM, and occupational therapist (OT) to accomplish this task. The OT will conduct ongoing evaluations, therapy, and follow up during job placement. The WT can benefit by staying actively involved during the day as well as gain a sense of belonging to his unit. The work mentorship program has positive results for the WT and his Family with a set goal for the WT to be returned to duty. The parent unit also has the Soldier either partially or fully engaged in his daily duty.
The commander's family readiness group. "The unit FRG [family readiness group] doesn't contact my husband or the WTU anymore; they forgot about us." -A Spouse of a Warrior in Transition
Once the Soldier is assigned to the WTU, the parent unit many times does not communicate with the WT or his Family. The WT and his Family no longer feel they are part of that parent unit and that ties have been cut. The commander and command sergeant major should make time on the calendar for visits to the WTU and/or to Families. Leaders should also involve the unit FRG when communicating with WTs and their Families. This may be difficult if the unit has changed commanders; however, ongoing WTU awareness training for FRGs can improve some of these difficulties. The parent unit's FRG representative can begin the process by becoming familiar with the nearest WTU. WTUs may have a representative such as the family readiness support assistant who can provide the WT and his Family with family support activities coordination.