The Defense Finance and Accounting Service (DFAS) recently launched their latest tool to help wounded warriors, those who are medically retired due to disabilities, understand how their retirement pay, Department of Veterans Administration compensation, and Combat Related Special Compensation (CRSC) are determined. Called the “Medical Disability Retired Pay Income Estimator,” the tool coupled with a detailed online PowerPoint tutorial can help wounded warriors estimate their combined Military and Department of Veterans Affairs post-retirement income and better understand the retired pay and compensation they are currently receiving.

Work on the “estimator” began in earnest after a group of Army Ombudsmen pointed out the need to help educate wounded warriors, family members, and local counselors on how retirement and disability pays work together and how the complicated rules and offsets affect their monthly payments. The confusion caused by these rules often leads to added frustration for the wounded warriors and their families.

Service members often find that the actual amount they receive is less than they expected. Being able to help manage their expectations earlier in the process helps avoid frustration and enables members to better plan their budget and future income needs.

To get an estimate of their future pay, users input their personalized data such as disability ratings, CRSC ratings, years of service, pay, and dependent information. In addition users who want a more in-depth explanation of the how the offsets work can take the online tutorial found at the DFAS website.

Developed by Wounded Warrior Pay Management team members Danielle Trumpey and Ryan Lindner, the tool is the latest step taken by the team in their ongoing work to ensure wounded service members receive the pay they deserve and fully understand the processes involved.

The team's work dates back to 2004 when it was dicovered that wounded Soldiers had been overpaid and were facing recoupment for indebtedness because their combat related pay was not stopped while they were being treated for their injuries at stateside military treatment facilities. The overpayments were the result of a lack of communication between the Soldier’s units and the pay center, which was not getting word that the wounded Soldiers had been medically evacuated out of the combat theater.DFAS responded by forming the Wounded Warrior Pay Management Office and establishing a Wounded Warrior database. In 2005 the team began working directly with the Army in to ensure wounded Soldiers would no longer get lost in the system.
In 2006 DFAS began supplementing Army Finance with civilian personnel. DFAS team members meet each wounded warrior as they arrive at Landstuhl Germany to explain the process and enter their pertinent information into the DFAS Wounded Warrior database. This face-to-face support doesn't end until they reach their home station. Wounded Warrior Pay Program Manager, Jerry Christensen said, “In the end, no matter the pay system, there will always be a need for the critical human dimension to provide world class, accurate and real-time financial support to the individual Wounded Warrior and their family members.” The end result is that each wounded warrior’s progress is now closely tracked as they transition through each part of their medical treatment and eventual retirement process.

In addition to the personalized service, through use of new streamlined debt management procedures, DFAS remitted, canceled, or waived debts for over 14,000 wounded warrior accounts totaling approximately $13 million. 

DFAS will be the first to tell you that their work is far from over, “we are actively engaged in continually improving Wounded Warrior pay support through customer based solutions,” Christensen added.

WASHINGTON, Dec. 17, 2009 – Doctors from Walter Reed Army Medical Center here and the University of Miami collaborated to perform the first pancreas islet cell transplant Thanksgiving Day on an airman whose pancreas was injured so severely in Afghanistan that it had to be removed.

While serving with an Army unit in Afghanistan, 21-year-old Air Force Senior Airman Tre Porfirio was shot three times in the back by an insurgent Nov. 21. Seventy-two hours and 8,000 miles later, Porfirio was at Walter Reed with injuries so extensive it would require 11 surgeries to reconstruct his abdomen.

Porfirio was taken to the operating room where Army Col. (Dr.) Craig D. Shriver, chief of general surgery, found the pancreas damaged to the point it was leaking dangerous enzymes that were causing blood vessels and tissue to break down.

“The only possible course of action at the time was to remove the remainder of his pancreas, which would predictably lead to a severe form of life-threatening and lifestyle-limiting diabetes,” Shriver explained to reporters at a Dec. 15 news conference.

Risks for this type of diabetes include blindness, kidney failure, amputations and strokes, as well as daily insulin injections for the rest of his life.

Over the last eight years of war, doctors at Walter Reed have seen only 28 pancreatic injuries, and only one of this devastating nature, officials said. The surgical team called the University of Miami and put together a plan to ship the damaged pancreas to Florida to harvest the cells that produce insulin -- called islet cells -- and immediately ship them back to Walter Reed to be transplanted into Porfirio’s liver.

All of this had to be done overnight, the day before Thanksgiving.

“I knew who the main players were in this case,” said Dr. Rahul Jindal, transplant surgeon. “I picked up the phone and called [Dr. Camillo Ricordi, chief of cellular transplantation, University of Miami] and, without hesitation, he said, ‘For a wounded warrior, I’ll bring my whole team.’”

“Being able to serve a wounded warrior who risked his life to defend us all, I can think of no better way to spend Thanksgiving,” Ricordi said.

In islet cell transplantation, the insulin-producing islets are isolated from the donor pancreas and then re-infused in a patient’s liver, where they begin to produce insulin, doctors explained.

“You turn the liver into a double organ as it takes on the function of the pancreas,” Ricordi said. “Normally, when similar procedures are done for Type 1 diabetes, the cells come from another person, so you need immunosuppressant drugs to keep them alive. Since we were able to use his own cells, he won’t need to be on anti-rejection drugs.”

The University of Miami team spent six hours isolating the islet cells before they were suspended in a specialized cold solution and flown back to Walter Reed. Ricordi helped to coordinate the transplant with the surgeons through an Internet connection, and on Thanksgiving Day, Porfirio’s own cells were successfully injected into a vein to his liver.

Porfirio’s blood tests show his harvested islet cells are functioning well, and he is gaining back his strength every day, doctors said.

“For anyone within a six-hour flight range of Miami, there is no reason any pancreas should ever be thrown away,” Ricordi said.