REPORT | March 28, 2023
Evaluation of the DoD’s Management of Traumatic Brain Injury (DODIG-2023-059)
Evaluations
Publicly Released: March 30, 2023
Objective
The objective of this evaluation was to determine the extent to which the Defense Health Agency and Military Service medical departments implemented policies and procedures and provided oversight to ensure that Service members who experienced a traumatic brain injury (TBI) were identified and screened to determine their appropriate level of care. In addition, we determined the extent to which the U.S. Central Command (USCENTCOM) Service Components screened, identified, and documented signs and symptoms of TBIs.
Background
As highlighted in the DoD OIG November 2021 report on traumatic brain injuries in the USCENTCOM area of responsibility, TBIs are one of the invisible wounds of war and one of the signature injuries of troops wounded in Afghanistan and Iraq. From 2000 to 2022, approximately 458,894 Service members were diagnosed with a TBI during training or in combat. Due to the high rate of TBIs, the National Defense Authorization Act for FY 2020 required the DoD to study the effectiveness of the use of routine neuroimaging in diagnosis, treatment, and prevention of brain injury due to blast pressure exposure during combat and training. In a 2020 letter to the DoD Acting Inspector General, the Congressional Brain Injury Task Force emphasized the importance of accurate and transparent reporting of traumatic brain injuries.
Finding
The DoD did not consistently implement policies and procedures to determine the care needed for Service members with TBIs. Specifically:
Military Health System (MHS) providers did not consistently identify and assess patients with TBIs;
the DoD did not implement consistent processes for the management of TBI care; and
the DoD did not implement consistent processes for the disposition of care, including return to duty status for patients diagnosed with a TBI.
https://www.dodig.mil/reports.html/Article/3346218/evaluation-of-the-dods-management-of-traumatic-brain-injury-dodig-2023-059/