V. 2.

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www.summitforsoldiers.org * mike@summitforsoldiers.org * (614) 314-5829
(Draft) 2013
Updated: 09 Dec 2013
Proposed: DoD (Form ####) Significant Event Tracker (SET)
CONCEPT:
The Significant Event Tracker (SET) is designed to be a cost-effective, low-burden tool
that utilizes already established resources within the DOD/Military to administratively
track and verify a Service-Members exposure to potential events typically related to
Post Traumatic Stress (PTS) or Traumatic Brain Injury (TBI). The process would include
entry of an event, verification of the event, storage of approved events into a centrally
maintained (secured) database, and production of an Official DoD document upon
discharge containing service related events.
Entries would be defined as any event or exposure that involves traumatic, violent, life
threatening, or potentially life threatening environments; sustained hazardous duty;
concussive and/or mechanical event that places individual at risk for PTS and/or TBI.
It would become the Service Members responsibility to track encounters and to log
these events into an online reporting system that would escalate to an approved agent
that would verify these entries against current (and future) reporting systems (TIC,
SITREPs, LOD, PCR, Unit Logs, etc), Command Leadership, and Medical Treatment
Facilities.
Once verified and approved, the officially recognized Event would be entered into the
secure, centrally maintained tracking database. Upon discharge, the Service Member
would receive a tamper-proof copy of the (SET) DD-#### along with their DD214. This
document would carry equal authority as the DD214/5 for verification by the VA and
other organizations to be used for care, treatment and compensation.
A key point is that this is an administrative tool (as opposed to diagnostic) which is
intended to be used to specifically document and confirm Events that have been
identified as potential Stressors that have been shown to be related to PTS/TBI claims,
and to do so as close to real-time as possible. The process and benefits shall be
explained throughout this document.
Summit for Soldiers: Proposed SET DD Form####
V.2.4
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(Draft) 2013
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ONE EXAMPLE of what the User Interface/Data Entry System might look like:
(EXAMPLE ONLY, Actual User Interface TBD)
The User Interface is envisioned as a CAC Card accessible data entry system that
would consist of various pull-down menus and selectable entries to decrease burden
and facilitate data entry, as well as, option and comment fields to elaborate upon or
specify unique events.
As an Administrative tool, the user interface would be developed on the concept of
factually based and easily verifiable information (who, what, where, when).
Defining the types of reportable events/entries will need To Be Determined beyond the
obvious (IED blasts, Combat engagements, WIA) however, as new risk factors are
identified, the system can be updated to reflect those concerns (ie, Sexual Assualt, burn
pit, etc).
STATUS:
Deployed
Hazardous Duty
Training
Normal Duty
Other
Date/Timeframe: Location: Unit:
Explanation:
EVENT:
Enemy Engagement
Witnessed Death/Injury
Non-Kinetic Patrol
Concussive Event
Head related Injury
Indirect Fire
Other
Was an Injury
Sustained
during Event:
YES
NO
Selectable Pull-Down Menus Free Text
Summit for Soldiers: Proposed SET DD Form####
V.2.4
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(Draft) 2013
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BACKGROUND:
PTS and mild TBI are considered the invisible wounds of war, and thankfully they have
finally been recognized as valid injuries sustained in the line of duty. Veterans with
service connected PTS/TBI related issues are eligible for treatment and compensation
though the Veterans Administration. Unfortunately, many of the difficulties associated
with determining a veterans eligibility revolve around verifying the veterans claim to
begin with. While great progress has been made to treat and compensate our veterans
won are suffering from these injuries, we still endure lengthy waits, a complicated
process, back-logged VBA, multiple appeals, fraudulent claims, etc which leads to
many veterans in need simply avoiding the system all together.
The process for verifying legitimate claims can be extremely frustrating to a veteran,
especially for those who have not been awarded a service qualifier (CAR, CIB, etc) that
designates them as a Combat Veteran." While most of the information in regards to a
units Significant Actions remain unclassified, veterans do not typically have general
access to this information. Even with the designator, it can still be extremely difficult and
frustrating identifying a point in time that qualifies as a recognized Stressor especially
for individuals who may be several years beyond the time they were exposed to their
service related issue, or for individuals that have had a period of exposure instead of
just a singular stressor. In fact most veterans who are reporting with mental health
related injuries most likely have been exposed to several events, over a lengthy period
of time, and several years removed from the time of occurrence. On top of that the
diminished cognitive state, and ability to recall while in crisis lends itself to perceived
discrepancies by the VBA that results to claims denial.
The similarities between the symptoms of PTS and TBI cases can easily result in
overlooking appropriate diagnosis for mild TBI, this could delay appropriate treatment,
particularly if the veteran struggles with accurate recall due too related cognitive issues.
An accurate history is key to identifying accumulative events that might suggest a mTBI.
Many times these events (singularly) seem insignificant, until you begin looking at the
accumulative number of events.
The VA pays out billions of dollars each year for service related disabilities, so it is
understandable that PTS, TBI and other mental health related claims are approached
with caution by the VBA system.
While the VBA is working hard to process claims, the growing backlog is resulting in
most veterans waiting up to several years to receive a decision. The frustration involved
with filing a claim (or even getting seen by the VHA in some cases) can be extremely
difficult for the veteran, especially for someone who is relying on this compensation due
to the inability to work. And while there are exceptions that allow expedited claims, the
majority of veterans must bear the burden of these inconveniences.
The difficulties, costs and time consumption required of the VA system to verify these
events (independently, years removed from the event, and with limited resources for
verification) must be enormous.
The need for a cost-effective verifiable means to simplify and expedite a
veterans legitimate claim for diagnosis, treatment, and compensation of
PTS/mTBI has never been more necessary.
Summit for Soldiers: Proposed SET DD Form####
V.2.4
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(Draft) 2013
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BENEFITS:
The SET as a recognized Official Document could provide the following benefits:
1. Cost effective real-time (close to real-time) verification of Service Members
potential PTS/TBI related events and exposure through currently established
DoD/Military resources and reporting systems, instead of the time-consuming
and potentially costly investigation/verification via the current VBA process.
2. Reduced burden on VBA claims process, minimizing future backlogs: (ie:
recognized official document that already identifies potential stressors close to
real time verses the current process of submitting a VA Form 21-0781 for
verification/scrutiny, often times requiring multiply submissions.)
3. An official document that provides Simplified/Expedited access, treatment, and
claims process for a veterans PTS/TBI related issues. (Clearly defined and
identified stressor expediting enrollment into the PTSD Clinic, for example.)
4. Secondary diagnostic tool and reference for VHA providers to differentiate
between PTS and TBI related events and steer a more appropriate treatment
process.
5. Veterans with PTS/TBI related issues that are beyond initial enrollment
opportunities (or other circumstances) could then bring in their DD214 and the
VA recognized SET Tracker, again eliminating lengthy time periods to get
treatment and/or claims decision.
6. Naturally reduces STIGMA, as all members would be required to report and
maintain their SET. Those less likely to come forward under the current process
could now have a safe means to report their potential stressors.
7. Better control through a more accurate reporting system can result in a reduction
of fraudulent claims and abuse of an already over-tasked system.
8. Database entries could be compiled for Statistical, Research and Medical
Studies.
PROCESS:
The submission, verification and approval process for entering events into the tracking
database would involve four primary steps: Event Submission, Event Verification,
Command Approval, and Event Storage and Processing.
1. Submission of an Event
a. Service Member Entry - It would be the primary responsibility of the
Service Member to enter and maintain events into their Member-
Specific tracker. Proper training and enforcement would fall under the
responsibility of the Unit Command Leadership.
i. Member is exposed to a reportable event.
ii. Member accesses CAC enabled user interface at earliest
convenience and enters information into system and then submits
for review and approval.
iii. Example of types of required information.
1. Name, Date, Location, Unit. (These could be auto-filled
with the ability to adjust if necessary.)
2. Duty Status (Deployed, Hazardous, Training, etc)
Summit for Soldiers: Proposed SET DD Form####
V.2.4
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(Draft) 2013
5
3. Type of Event (Patrol, IED, Witnessed death, etc)
4. Injury sustained as a result (Y/N)
5. etc
b. Command Witnessed Entry - Unit/Team leadership that witnesses an
event affecting entire team/unit, could be authorized to directly enter that
event for ALL members affected.
c. Medical Treatment Facility Entry For those members WIA requiring
escalated care and treatment, the MTF would issue a direct entry into the
tracker.
d. Reportable Events include, but not limited to: (Details TBD.)
i. Kinetic Combat Patrols
ii. Witnessed loss of life/dismemberment.
iii. Exposure to life-threatening or perceived life-threatening
environments.
iv. Sustained exposure to hazardous duty (ie: multiple non-kinetic
combat patrols, etc)
v. Potential TBI qualifying injury or exposure, to include both
concussive and mechanical events involving the head.
vi. etc
2. Event Verification
a. For Individually entered events, an Authorizing Agent (TBD), most likely
would be an admin at the units command element, would have access to
the tracking entry system (not the main storage database) to verify
entered events. After verification/denial the entry would be escalated for
approval by Command Leadership. Verification tools include:
i. DoD/Military Reports (TIC, SITREP, PCR, Patrol Order, etc)
ii. Unit Logs
iii. Unit Medical Department
iv. Creditable Witnesses (patrol leaders, etc)
b. Direct Entry from Unit/Patrol Leadership would escalate directly to the
Command Approval process.
c. MTF Entered Event would escalate directly to the Main Tracking
Database.
3. Command Approval
a. Commanding Officer (or designation) would have exclusive access to
Approve and Submit the verified entry into the Secured Tracking
Database.
b. The Commanding Officer reserves the right to contest an entry (approved
or denied) contested submissions could be stored in the database for
future examination, but not printed on official discharge document.
i. APPROVED: Clear documentation and verification of facts and
individuals exposure.
ii. APPROVED/CONTESTED: Clear documentation and verification
of event, however, CO maintains reasonable doubt for approval.
iii. DENIED/CONTESTED: Questionable documentation or
verification, however, CO maintains reasonable doubt for denial.
iv. DENIED: No clear evidence of entered facts, or individuals
exposure to claim.
Summit for Soldiers: Proposed SET DD Form####
V.2.4
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(Draft) 2013
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4. Event Storage and Processing
a. Once verified and approved at the command Level, the Event would be
forwarded to a centrally stored, secured Database where it would become
an official entry into the members SET. (MTF entries would escalate
directly to this stage.)
b. Upon discharge from Active Service, an Authorizing Agent (TBD) with
cleared access to the Tracking Database would generate an official (SET)
form DD####, that would be issued to member along with their DD214.
DISTRIBUTION AND CONTROL:
The SET would be distributed in accordance and consistent with the Military
Services internal requirements and instructions.
Here is an example of the current DD214/5 Distribution process:
Copy 1 Service Member
Copy 2 Service Personnel File
Copy 3 United States Department of Veterans Affairs
Copy 4 Member (if initialed in Block 30)
Copy 5 United States Department of Labor
Copy 6 State Director of Veteran Affairs
Copy 7 & 8 Distributed in accordance with Military Service Department
directions
Service member will receive their official copy upon discharge; however, a copy shall be
maintained within the Service Members Medical Record/Medical Department while on
Active Duty/Active Reserve status.
Electronically storage and distributing will be maintained and controlled by government
compliant standards and format.
Official Hard Copy form will be in a tamper-proof format.
CONTRIBUTIONS:
The Office of Sen. Brown (Ohio)
Ohio USMC Wounded Warrior Regiment
VHA OIF/OEF Case Workers
Veteran Service Officers
Service Connected OIF/OEF Veterans
Military Unit Leaders
Military Unit Healthcare Providers
Resurrecting Lives (TBI) Foundation
The Office of Rep. Tiberi (Ohio)
The Office of Sen. Portman (Ohio)
VFW
Summit for Soldiers: Proposed SET DD Form####
V.2.4
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(Draft) 2013
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EXAMPLE of what an Official DD#### Form might look like:
Summit for Soldiers: Proposed SET DD Form####
V.2.4
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(Draft) 2013
8
EXAMPLE: STEP by STEP Process and Flow
A. SELF REPORTED
EVENT
2. MEMBER ENTERS EVENT
!
3. EVENT VERIFIED
B. COMMAND
WITNESSED EVENT
C. MTF/HOSPITAL
ADMISSION
1. EVENT SUBMISSION
5. MAIN DOD SECURED TRACKER DATABASE
6. DISCHARGE SET
DD FORM####
4. COMMAND APPROVAL
or CONTESTMENT