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Naval Hospital Bremerton Med Board and Navy Wounded Warrior Supporting Those in Need

05 December 2023

From Douglas Stutz

They’re adept at unraveling red-tape, proficient at moving mounds of paperwork and practiced at navigating bureaucracy.All that – and more – is just standard support, guidance and expertise provided by Naval Hospital Bremerton’s Medical Board department for servicemembers confronted by the daunting prospect of dealing with a serious injury or
They’re adept at unraveling red-tape, proficient at moving mounds of paperwork and practiced at navigating bureaucracy.

All that – and more – is just standard support, guidance and expertise provided by Naval Hospital Bremerton’s Medical Board department for servicemembers confronted by the daunting prospect of dealing with a serious injury or illness and needing lengthy medical care.

Medical Board department support is part of a crucial overlapping design, along with non-medical care from Navy Wounded Warrior, to care for those in need.

According to April C. Dinucci, NHB/Navy Medicine Readiness Training Command Bremerton Medical Board department supervisor, the behind the scenes – and reams – work done by her team is almost as invisible as it is integral.

“Our Medical Evaluation Board staff aid all Wounded Warriors in the entirety of all medically related processes. We are the experts that handle the medical administrative nuances of physical and mental health cases from cradle to grave. My staff are here to assist from the onset of Limited Duty until the member transitions from service,” said Dinucci.

Along with collaborating with Navy Wounded Warrior, the Medical Board team also coordinates with the Disability Evaluation System Counsel Program, VA military service coordinators, command deployability coordinators, Navy and Marine fleet forces leadership, branch service headquarters and the Physical Evaluation Board in Washington, DC.

“We are your physical evaluation board liaison officers,” exclaimed Dinucci, who along with being a PEBLO is a disability counselor and subject matter expert in the Disability Evaluation System, Limited Duty and Temporary Disability Retirement program(s).

As the department name suggests, they handle medical evaluation boards and serve as the main point of contact for questions or concerns regarding case status, findings, benefits, personal - and personnel – inquiries and demands.

“We’re the experts in disability evaluation,” Dinucci said, noting that Navy Wounded Warrior provides expanded coverage for service members on LIMDU or enrolled in DES as well as providing vital non-medical assistance for personal and social needs.

The Navy Wounded Warrior – previously known as Safe Harbor - supports Sailors and Coastguardsmen with serious physical and mental illness, non-combat and combat wounds, and injuries sustained on duty or liberty.

Adrian Alegria, Navy Region Northwest Navy Wounded Warrior recovery care coordinator affirms that Navy Wounded Warrior is the benchmark for non-medical care in providing resources for education and employment initiatives, adaptive reconditioning programs, family and caregiver tools and more which promote healing, and help enhance opportunities for success, both within and beyond military service.

“Coordinating non-medical care enables service members to focus on their recovery goals and well-being, encourages retention and return to duty, and supports a smooth transition to the VA when a condition prohibits continued service,” said Alegria, who in his role helps develop comprehensive recovery plan by identifying goals and resources, such as assistive technology, education, employment, or housing to rehabilitate service members back to active duty or transition into the civilian community after their military career.

Navy Wounded Warrior is the Navy’s sole organization for coordinating the non-medical care of seriously wounded, ill and injured Sailors and Coast Guardsmen, and providing resources and support to their families.

The referral process to determine eligibility usually originates from various physical evaluation board liaison officers and medical care case managers across Navy Region Northwest.

“However, we can receive a referral from anyone. It doesn’t have to be a medical professional to refer servicemembers,” Alegria said.

Whether it’s a self-referral, from a family member, and/or sent from a military command, there are several ways to contact Navy Wounded Warrior in the Pacific Northwest:

• Recovery Care Coordinator: Adrian Alegria,
• Non Medical Care Manager: Lt. Steven Martinez,
• Regional Director: Edward Garcia,

Alegria’s involvement begins once an referral is received. He contacts the servicemember to conduct an initial assessment. Enrollment is predicated by the severity and longevity of the illness/injury recovery process.

“A typical recipient is usually undergoing a medical evaluation or possible med board. Once enrollment occurs, we create a tailored recovery plan to meet immediate non-medical needs and forecast potential needs for the servicemember and/or family,” Alegria said.

For those eligible, there is individualized - and practical – guidance on non-medical care, including,
Caregiver resources/respite care
Bedside travel
Job training
Adaptive reconditioning

Compiled data helps explain NHB’s Medical Board department demanding workload. For Fiscal Year 2023, the Medical Evaluation Board staff managed 712 LIMDU cases, with an average of 307 open cases each day being actively processed by the Med Board team. Combined with the approximately 250 Disability Evaluation System open cases to determine a servicemembers fitness for duty, that’s nearly 560 open cases being tracked by the Med Board team.

Possibly the most challenging aspect when providing medical support for those going through the process, as well as coordinating with Navy Wounded Warrior, is dealing with time management and expectations by servicemembers and their families.

“When someone is placed in an MEB the expectation may be that their case will conclude in 90 days. The reality is that timelines [can] exceed nine months. This is for the administrative process, treatment times vary and are impacted by a multitude of factors that often increase the overall timelines even further,” explained Dinucci.

“We communicate with the Physical Evaluation Board Liaison Officers and medical case managers to obtain information to better serve the servicemember. They give vital updates which help drive the servicemember’s comprehensive plan,” affirmed Alegria.

Alegria admitted that it can seem like an arduous process at times for a servicemember and their family being navigated through the uncertainty and unknown.

“Most of our clients are in a distraught state. Many of them were hoping, to one day, retire from the Navy which they’ve proudly served. Now there’s a potential for them to be medically separated. We try our best to mitigate the stressors of transitioning out of active-duty service,” stated Alegria, adding that it is gratifying to assist someone with their non-medical needs which many times were completely unknown to them.

When asked what he wants everyone to know about the Navy’s Wounded Warrior, Alegria replied, “Even though our team serves Navy Region Northwest, Navy Wounded Warrior services are worldwide. No matter where servicemembers go in their Navy journey, Navy Wounded Warrior will be able to assist our servicemembers and their families.”

NHB’s Medical Board department coordinate assistance and training primarily across the five-state region of Alaska, Idaho, Montana, Oregon and Washington. Their team includes:

Medical case managers who assist in the medical needs of the member, such as discharge planning, durable medical equipment and specialty services.

“And everything else we ask; they are the heart of our medical team.” added Dinucci.

Physical Evaluation Board Liaison Officers who advise personnel on their fitness for duty status, explains rights and entitlements and handles documentation in determining if a servicemember in entitled to disability benefits.

“We are the axle in the wheel of the Disability Evaluation System process,” Dinucci said.

Limited duty coordinators who are responsible for placing members LIMDU, notifying commands, updating re-evaluations, conducting monthly case reviews.

Fleet Liaisons who manage personnel casualty reports, decedent affairs and command notifications of hospitalizations. They also handle such distinctive needs as helping coordinate a family requiring bedside assistance for a hospitalized Sailor or Marine.

“There is a myriad of people involved in caring for ill/injured Sailors and Marines. It can be complicated to keep it all straight. Keep a notebook with who the key players are, their emails, phone numbers, titles. With the increase in virtual encounters, this can be immensely helpful for the member and their family,” stated Dinucci.

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