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GAO: Many health assessment forms go missing

A congressional watchdog agency reported Thursday that the Defense Department cannot locate post-deployment health questionnaires for more than 72,000 people — about 23 percent of service members who have returned from combat since Jan. 1, 2007, when the detailed assessments were supposed to be kept for anyone deployed for 30 days or longer.

Missing questionnaires might be the result of returning service members deciding not to complete the form, which is supposed to detail any post-deployment health problems or concerns. But it is also possible that completed forms were lost, the Government Accountability Office says in a report to Congress.

Whatever the cause, the absence of such a large percentage of records is significant because one purpose for collecting the information was to look for trends in health issues and to be able to track people with similar reports of minor problems to see if they become something larger.

Defense officials acknowledge this is a serious issue. In a written response to the report, Ellen Embrey, the acting assistant defense secretary for health affairs, said, “We must be more aggressive.”

Every service has problems, according to the report, but the Army and Air Force seem to be doing a better job than the Navy and Marine Corps in getting completed questionnaires to a central repository, the report says.

The Army has 36,510 missing reports, the largest number of all of the services. But this represents just 19.6 percent of the people who have returned from Iraq and Afghanistan, the report says.

The Air Force has 8,162 missing reports, 15.8 percent of those who had returned from the combat theaters.

The Navy has the lowest number of missing reports, 5,938, but it has the highest percentage gap, at 44.3 percent, because it has deployed far fewer people than the other services.

The Marine Corps is missing 21,751 questionnaires, which represents 32.1 percent of the returning Marines.

The Defense Department started using a post-deployment health assessment in 2005, with a goal of having everyone complete the form within 90 to 180 days of their return from Iraq or Afghanistan.

Some of the current form is voluntary and some is mandatory. Service members must complete the demographic data identifying who they are, where they deployed and other information. The self-assessment about their health, including mental health, is voluntary. The form is electronic, and it is supposed to be submitted to a central repository when completed and a copy added to the service members’ medical records.

The report notes that only about 1 percent of returning service members refuse to complete the health portion of the report, with the refusal rate being the greatest in the Air Force, where up to 5 percent don’t complete the health questions.

Every form is supposed to be reviewed by a health professional, and service members who report problems are supposed to be given a chance to discuss them, the report says.

Because everyone is supposed to fill out the form, the absence of so many questionnaires shows policy is not being followed, the report to Congress says.