Ms. Bilmes concluded that veterans returning from Iraq and Afghanistan with PTSD or TBI are likely to encounter long treatment delays and bureaucratic conflicts during the initial period after the trigger incident. Delayed treatment may lead to slower recovery and increased medical, disability, and social costs, which may eventually exceed the operating costs of the war. However, she believes that many problems can be corrected. She has proposed 17 specific reforms, including a more seamless transition between the DOD and VA, particularly for patients with TBI and PTSD. “A key recommendation I have made is to shift the ‘presumption,’ so that veterans with a TBI or concussive event are presumed to have been injured during active duty. This would mean they no longer had to prove that their injuries resulted from warfare—and it would change the basis of the entire veterans’ process.”
—Jessica Jannicelli