Army Veteran Struggles to Receive Brain Treatment As a Private Contractor

PHOTO: Jennifer Barcklay, an army veteran awaiting approval for cognitive rehabilitation therapy from her insurer.
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Jennifer Barcklay, a civilian contractor who was injured by a bomb in Afghanistan, will finally receive therapy for a traumatic brain injury after a nearly two-year fight to get treatment. While Barcklay, an Army veteran, needed specialized medical treatment after serving her country, she faced two problems. She is a private contractor in Spokane, Wash., living miles away from hospitals offering that treatment.

On Wednesday, almost two years after she survived a mortar blast in Afghanistan and one year after doctors first recommended cognitive rehabilitation therapy, her insurer agreed to pay for this expensive treatment. She and her attorney, David Linker, received approval in the form of a letter dated June 15, approving travel arrangements and treatment at a specific facility in California.

After the long waiting period, Barcklay said she has mixed feelings.

"I'm happy that they're finally doing what they're supposed to do, but I'm not sure about the whole process," she said. "What it put me and my family through was horrible."

Barcklay, 40, worked for defense contractors starting from 2006 after being honorably discharged from the Army in 1996 for a knee injury. But her private insurance won't cover her cognitive rehabilitation therapy, as first reported by the Spokesman-Review.

The therapy is an expensive treatment that thousands of U.S. soldiers are receiving. Those soldiers can usually obtain treatment from Department of Veterans Affairs facilities because they obtained the injuries while on active duty.

Military contractors are often in dangerous war zones but denied medical benefits despite statutory protections.

The Defense Base Act of 1941, in fact, requires defense contractors to provide medical and disability insurance for their employees in war zones.

Congress pledged to look further into the failings of the Defense Base Act program, including a House oversight committee hearing on the issue in June 2009, as the reliance on military contractors has increased.

The Department of Defense submitted a report to Congress in September 2009 recommending improvements to the Defense Base Act program. A spokeswoman for the Department of Defense referred ABC News to the Department of Labor for this story. The Labor Department was not immediately available for comment.

More civilian contractors than soldiers died in war zones from January to June 2010, according to the nonprofit news provider, Pro Publica.

Barcklay, on the other hand, was a civilian helicopter mechanic when she obtained her injuries. In September 2009, an enemy mortar exploded 10 yards away from her at Forward Operating Base Shank in Afghanistan. Back then, she worked for Presidential Airways, a subsidiary of security contractor, Blackwater, which changed its name to Xe Services in 2009.

The blast, which severely injured two other people, slammed her into the ground, causing ear trauma, joint pain and, she says, it continued to cause frequent seizures.

She came to the U.S. in November 2009 and, despite blurred vision, vertigo and other problems, returned to Afghanistan in January to continue working. After she returned home again in February 2010, she saw physicians for her memory loss, seizures and pain.

Dr. Neil Giddings of the Spokane Ear, Nose and Throat Clinic and neuropsychologist Dr. Winifred Daisley recommended cognitive rehabilitation therapy as early as March 2010, according to the Spokesman-Review.

Her insurer, Chartis Insurance, a division of AIG, is paying her weekly wage compensation and her doctor visits, but they delayed approving cognitive rehabilitation therapy. But the expensive inpatient therapy is not available in the Pacific Northwest, and Barcklay said she is suffering each day she does not receive the treatment.

"The longer I wait with a brain injury, the longer I could have permanent injury," Barcklay said. "All I want is the ability to get back to work, to get my mind back."

First, Barcklay said her claims adjustor retired without notice. Then Chartis hired a nurse case manager to handle Barcklay's case, who contacted the Centre for Neuro Skills in Bakersfield, Calif. after finding there was no similar center nearby. But Barcklay said that nurse was terminated in October 2010.

Marie Ali, a spokeswoman for Chartis Insurance, provided a statement from the company:

"While we do not comment publicly on the specifics of individual claims, Chartis is committed to handling every claim professionally, ethically and fairly. We provide the highest level of service to our insureds, which includes the prompt adjudication and payment of claims."

A spokesman for Xe Services, which sold Presidential Airways to aviation company AAR Corporation in April 2010, provided a statement to ABC News regarding Barcklay's situation.

"While the company no longer is affiliated with Presidential Airways, it remains concerned about Ms. Barclay's situation and continues to work with the insurance provider to help ensure she receives the level of care and treatment she needs," according to Xe Services' statement.

Barcklay, who studied art and archaeology at Evergreen State College before joining the Army, was hoping to get a master's and doctoral degree in philosophy before the blast.

"I was working towards a doctorate for crying out loud and now I don't know my times table," she said.

From at least March 2010 through February 2011, eight doctors have recommended Barcklay travel to receive special treatment for her blast injury at the Centre for Neuro Skills in Bakersfield.

Waiting for Medical Treatment Despite Doctors' Recommendations

Dr. Neil Giddings wrote on February 1: "once again, I strongly recommend evaluation and a comprehensive program, which does not appear to be available in Spokane, Washington area for traumatic brain injuries using experts who have expertise in these blast injuries."

Barcklay said she has shared the doctors' recommendations with Chartis, but she said her insurer has made her jump through hoops to receive her necessary treatment, including assigning her multiple caseworkers.

Finally, the insurer requested an independent review from a doctor in Rhode Island who has never examined Barcklay. That doctor reported on May 18 that Barcklay was suffering from a mental condition and she did not need the cognitive rehabilitation, a diagnosis which Barcklay and her doctors contest.

"My doctors will not let me go back to work because I'm neurologically unstable with seizures," she said. "That cannot be diagnosed where I live in Spokane, Washington."

On June 8, the Office of Workers' Compensation of the Labor Department, issued a recommendation that the "employer/carrier allow Ms. Barcklay to be evaluated by the Centre for Neuro Skills…for the purpose of determining whether she is a suitable candidate for inpatient treatment."

Now, Barcklay will receive the treatment after months of waiting.

Chartis' response on Wednesday prevented litigation through the Labor Department's trial courts. Barcklay said even with the treatment, she is concerned the delay in receiving treatment will hamper her rehabilitation.

"The fact is we all have to go through this process. We have to hire attorneys and fight them for care recommended by doctors that AIG hired and they deny it for no reason for this long," Barcklay said about other civilian contractors. "We shouldn't fight for what's right. We're legally obligated for this treatment and we shouldn't have to fight so hard."

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