Watchdog Investigation of Pentagon Traumatic Brain Injury Efforts Requested by 22 Lawmakers

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Model of a brain at Traumatic Brain Injury Open House event
Department of Defense civilians and active duty service members attend a Traumatic Brain Injury Open House event March 20, 2014, at Tripler Army Medical Center located in Honolulu. (U.S. Air Force photo by Staff Sgt. Christopher Hubenthal)

A large, bipartisan group of lawmakers say they have concerns over how the Pentagon is tracking traumatic brain injuries among troops and whether it's taking the issue seriously -- and they want a government watchdog to look into it.

In a letter shared exclusively with Military.com, 22 members of Congress, led by Sens. Elizabeth Warren, D-Mass., and Joni Ernst, R-Iowa, are asking the Government Accountability Office to review the Pentagon's efforts to identify, prevent and treat traumatic brain injuries related to service members' exposure to blast overpressure, the term used to describe the concussive effect of munitions.

The move comes amid growing evidence that troops are at risk of exposure to dangerous blast pressure not just from enemy bombs and attacks but also from routine military activities such as repeat artillery fire.

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Military.com has reported extensively on the impacts and devastating symptoms that brain injuries resulting from blasts are causing for service members and veterans. Traumatic brain injury, or TBI, is also linked to an increased risk of suicide among veterans.

In the letter released Thursday, the lawmakers are asking the GAO to investigate not only who at the Defense Department is doing research on TBI, blast overpressure and blast exposure but also how those efforts are being coordinated and what improvements have been made to prevent, diagnose and treat the injuries.

    "The department needs to take more urgent action to mitigate blast overpressure and support service members. ... Otherwise, troops will continue to struggle to get the care they need and deserve," the letter said.

    The lawmakers also note that, while the Pentagon spent almost $3 billion on TBI research between 2020 and 2023, "major gaps remain in turning this research into action to better protect service members' brain health, particularly to mitigate the impact of blast exposure and overpressure on service members."

    Military.com has reported that the Pentagon has long known about the possibility that TBIs are dangerous but squandered the opportunity to get ahead of the issue.

    Top-ranking military officials said that military doctors were strenuously downplaying the severity of the injuries as far back as 2009 and, in turn, affecting the care of hundreds of thousands of service members who would suffer brain injuries in the years that followed.

    Meanwhile, medical studies, such as this one published in 2022, were finding that the suicide rate among veterans who experienced a mild TBI, also known as a concussion, was three times higher than the general population, and that those with moderate to severe brain injuries were five times more likely to die by suicide.

    The lawmakers also want to know what steps the Pentagon is taking to protect service members from retaliation for coming forward to seek care for traumatic brain injury and whether barriers exist for troops who seek care midcareer rather than just before retirement.

    This isn't the first effort that Congress, and Warren and Ernst specifically, have put forward to deal with the issue.

    In April, the pair, along with Rep. Ro Khanna, D-Calif., sponsored a bill that would require the Pentagon to consider ways to reduce explosive pressure when it buys new weapons and publish safety information for weapons already in use. The proposed law would also mandate that service members' blast exposures be systematically logged and that a new brain health program be created for the special operations community.

    That bill would also require the GAO to review Defense Department efforts to address blast exposure.

    Related: Lost Years and Missed Opportunities: How the Pentagon Squandered the Chance to Combat Brain Injuries

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