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Brain Damage Therapy Not Covered by Pentagon’s Health Plan

Cognitive rehabilitation therapy is the process where brain injury patients relearn basic tasks such as counting, cooking and remembering directions. Research has shown that it aids patients with diminished function due to head trauma. However, Tricare, an insurance program that covers nearly 4 million active-duty military and retirees, does not believe the research is well-proven and refuses to cover the treatment.

The Pentagon convened 50 civilian and military brain specialists who all concluded that cognitive therapy was effective in aiding brain-damaged troops. Studies in recent years have also reached the same conclusion. Tricare refuses to cover the treatment citing its regulations requiring scientific proof of the effectiveness and quality of treatment.

However, an investigation found that in private meetings, Tricare officials expressed concern about the $15,000 to $50,000 per soldier cost of cognitive rehabilitation therapy. That cost could skyrocket given the number of troops suffering from head injuries. However, a Tricare director said cognitive therapy’s holistic methods make it difficult to measure the treatment’s effectiveness.

Aggressive campaigns from medical groups, Senators and Representatives to convince Tricare to cover the rehabilitation failed to convince Tricare to cover the treatment. Tricare responded with a letter saying the research on the effectiveness of cognitive rehabilitation therapy had not met the required standard.

If you or a loved one has suffered brain trauma due to another person’s negligence, a Washington, D.C. personal injury lawyer may be able to help. Contact Roger C Johnson a Washington, D.C. personal injury attorney at Koonz, McKenney, Johnson, DePaolis & Lightfoot.