For two years, a Joint Base Lewis-McChord soldier tried to run on a fractured ankle before he accepted that it wouldn’t heal and agreed to take a medical retirement.
Yet when he saw a doctor at Madigan Army Medical Center for a physical examination that would help set his disability pay, “my socks and shoes didn’t come off,” he said.
It was a conspicuous omission that left him with questions about his doctor’s visit as soon it ended. Later, he said, his disability ratings did not reflect damage to his foot he developed while trying to run through his injury.
That sergeant is one of at least 13 who’ve reported similar complaints about Dr. Lisa Ho, who was hired by a Lockheed Martin subsidiary called QTC Medical Services to carry out physical exams of military service members in the early stages of the medical retirement process at Madigan.
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The News Tribune spoke with 10 who shared consistent stories about short exams and other perceived oversights between September and January.
QTC reassigned Ho after Madigan officials raised patient complaints about her in late January. It was the second time Madigan staff members raised concerns about the doctor, Madigan officials said in a written response to questions from The News Tribune.
The Army has not called back soldiers Ho screened to schedule new exams. Redoing those exams and reassessing disability ratings could take months.
Taking that step is a decision that rests with the VA’s Veterans Benefits Administration, which manages the QTC contract and is responsible for determining disability ratings for veterans.
Ho did not return a message left at her office. A QTC spokeswoman on Monday declined to comment, deferring to the VA.
The VA on Monday said it carried out an independent review of the ratings it assigned to the 13 soldiers who filed formal complaints regarding their exams with Ho. It started that review after The News Tribune called the agency last week.
That review concluded her exams “were sufficient for ratings purposes.” Ho saw 366 soldiers at JBLM last year and in early 2016.
Some of the doctor’s former patients say they’re unsatisfied with that resolution. To them, removing her shows the Army and VA lost confidence in her work even as they stand by her reports in their disability ratings.
“It would be one thing if I was the only person,” said the 26-year-old sergeant who reported to the disability system because of his damaged ankle. The soldier asked The News Tribune not print his name because he is still in the Army and worried about retaliation.
“It’s a consistency of betrayal,” he said. “I feel like there should be a re-examination. There’s a trend.”
How can you find out when you don’t even touch me?
Spc. Michael Dankwah
The disability complaints echo a 2012 scandal at Madigan that led to nationwide reforms in Army behavioral health programs.
In that instance, Madigan forensic psychiatrists adjusted mental health diagnoses late in the medical retirement process for reasons soldiers did not understand and in ways that sometimes cost them long-term benefits.
Joint system aims to speed benefits
The soldiers were participating in a medical retirement process known as the integrated disability evaluation system (IDES). It merges health reviews by the Army and the VA for troops who cannot continue to serve in the military because of physical injuries.
If all goes well, the soldier will be out of the military within nine months and receiving VA benefits and an Army retirement. That income and health care should help soldiers leave the structure of the military behind and make fairly easy transitions to the civilian world.
The military medical retirement is intended to compensate a soldier for an Army career cut short by injury. A soldier with a low disability rating of 30 percent would get about $600 a month.
VA benefits are paid to former troops who were injured in their time of service. An unmarried veteran with no children who received a 100 percent disable rating would get about $2,900 a month.
The joint IDES system influences both rates. QTC Medical Services is involved because the VA uses its privately hired doctors to help set disability ratings for veterans of all generations. The VA paid the company about $175 million last year, according to records at the federal contract database called usaspending.gov.
Ho’s exams took place at the beginning of the medical retirement process. They were one of several factors that VA and Army staff used to determine disability ratings for patients. VA officials review those recommendations at local and national levels, said Pritz Navaratnasingam, the director of the Veterans Benefits Administration Seattle Regional Office.
“The quality of our work is validated throughout the entire (medical retirement) process,” he said.
Spokesmen for the Army and the VA noted that soldiers can appeal ratings at several points before they separate from the Army, meaning they have opportunities to get new medical examinations without a formal review of Ho’s work.
Most of the soldiers The News Tribune interviewed said they did not bother to appeal because they were frustrated by the process and did not want to prolong it.
“They told me they couldn’t do anything about it,” said Spc. Michael Dankwah, 29, who served in a combat hospital unit.
She was talking to him in a condescending tone, as if he was trying to run amok and take advantage of the system.
He sought a medical retirement because of back and leg pain. He said the doctor did not pay attention to his back during his visit.
“How can you find out when you don’t even touch me?” he asked.
Ho was known for months among lawyers and advocates for wounded soldiers as someone who produced reports that frustrated soldiers, particularly in determining an injured person’s range of motion, soldiers said.
It’s possible that her exams were accurate, but her manner somehow did not meet the expectations soldiers brought with them to their visits. In that case, her work could stand scrutiny if the VA chooses do a larger review.
Ho received additional training in February 2015 when Madigan staff members first raised concerns about her examinations, Madigan officials said.
By last fall, soldiers brought a new set of complaints about her screenings to their advocates.
“It seemed like she was rushing through with it,” said Spc. Charles Wylie, 38, of Lakewood, who received a medical retirement this year for injuries to his knees and shoulder. He was discharged from the Army this week.
The Army wants an efficient medical retirement process because it’s one of the main ways ground-level units can clear their rosters of injured soldiers and replace them with healthy troops.
The Army at JBLM has poured resources into the program since 2012, viewing it as a way to treat injured soldiers well while also improving the readiness of units that could be called up for missions overseas.
While soldiers await medical retirements, they often feel like burdens because they cannot participate in exercises with their teammates. That’s one reason they often approach the medical retirement process with guarded attitudes.
“I couldn’t continue with doing activities and doing my job,” said Spc. Innocent Quarshie, 39, who deployed to Afghanistan twice with Army aviation units. “I wasn’t able to lift. I wasn’t able to (exercise). I wasn’t able to run. It became like I was deadwood in the Army.”
Quarshie, an immigrant from Ghana, had his medical examination for his back injuries at Madigan on Oct. 15. He said Ho did not pay much attention to his limited movement in his lower back. Quarshie’s wife said the doctor also disregarded the soldier’s headaches, sleeplessness and shoulder pain.
The visit strained their marriage for a time, Quarshie said, because he found the doctor’s comments insulting, and that increased the depression he felt because his injuries prevented him from serving at his full strength.
“She was talking to him in a condescending tone, as if he was trying to run amok and take advantage of the system,” said Quarshie’s wife, Anetra.
Quarshie’s separation from the Army moved quickly after his visit with the doctor. He was discharged in February. His disability ratings determined his injuries did not qualify for an Army medical retirement, but gave him a high VA rating.
He has not appealed the decision, although he and his wife believe he was treated unfairly. They’ve moved to Ohio, where Anetra is working in medical billing and supporting her husband.
“We just want a fair decision and I think since they used her final report, I don’t think he was given a fair chance,” Anetra said.