[House Hearing, 116 Congress] [From the U.S. Government Publishing Office] [H.A.S.C. No. 116-33] FERES DOCTRINE--A POLICY IN NEED OF REFORM? __________ HEARING BEFORE THE SUBCOMMITTEE ON MILITARY PERSONNEL OF THE COMMITTEE ON ARMED SERVICES HOUSE OF REPRESENTATIVES ONE HUNDRED SIXTEENTH CONGRESS FIRST SESSION __________ HEARING HELD APRIL 30, 2019 [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] ______ U.S. GOVERNMENT PUBLISHING OFFICE 37-500 WASHINGTON : 2020 SUBCOMMITTEE ON MILITARY PERSONNEL JACKIE SPEIER, California, Chairwoman SUSAN A. DAVIS, California TRENT KELLY, Mississippi RUBEN GALLEGO, Arizona RALPH LEE ABRAHAM, Louisiana GILBERT RAY CISNEROS, Jr., LIZ CHENEY, Wyoming California, Vice Chair PAUL MITCHELL, Michigan VERONICA ESCOBAR, Texas JACK BERGMAN, Michigan DEBRA A. HAALAND, New Mexico MATT GAETZ, Florida LORI TRAHAN, Massachusetts ELAINE G. LURIA, Virginia Glen Diehl, Professional Staff Member Dan Sennott, Counsel Danielle Steitz, Clerk C O N T E N T S ---------- Page STATEMENTS PRESENTED BY MEMBERS OF CONGRESS Kelly, Hon. Trent, a Representative from Mississippi, Ranking Member, Subcommittee on Military Personnel..................... 3 Speier, Hon. Jackie, a Representative from California, Chairwoman, Subcommittee on Military Personnel................. 1 WITNESSES Figley, Paul F., J.D., Professor of Legal Rhetoric, American University Washington College of Law........................... 13 Lipe, Rebecca, J.D., Former Air Force Judge Advocate and Associate Attorney, Steptoe & Johnson, LLP, Service Women's Action Network................................................. 10 Stayskal, SFC Richard, USA, Special Forces Green Beret........... 5 Stirling, Dwight, J.D., LL.M., Chief Executive Officer, Center for Law and Military Policy.................................... 12 Witt, Alexis, Widow of SSgt Dean Witt and Advocate for Feres Doctrine Reform................................................ 8 APPENDIX Prepared Statements: Figley, Paul F............................................... 114 Lipe, Rebecca................................................ 62 Speier, Hon. Jackie.......................................... 37 Stayskal, SFC Richard........................................ 40 Stirling, Dwight............................................. 73 Witt, Alexis................................................. 51 Documents Submitted for the Record: ``Rethinking Feres,'' by Andrew F. Popper.................... 141 Witness Responses to Questions Asked During the Hearing: [There were no Questions submitted during the hearing.] Questions Submitted by Members Post Hearing: [There were no Questions submitted post hearing.] FERES DOCTRINE--A POLICY IN NEED OF REFORM? ---------- House of Representatives, Committee on Armed Services, Subcommittee on Military Personnel, Washington, DC, Tuesday, April 30, 2019. The subcommittee met, pursuant to call, at 2:12 p.m., in room 2118, Rayburn House Office Building, Hon. Jackie Speier (chairwoman of the subcommittee) presiding. OPENING STATEMENT OF HON. JACKIE SPEIER, A REPRESENTATIVE FROM CALIFORNIA, CHAIRWOMAN, SUBCOMMITTEE ON MILITARY PERSONNEL Ms. Speier. Good afternoon. This hearing will come to order. I want to welcome everyone to the Military Personnel Subcommittee of the Armed Services Committee on a hearing that we are having today on what has been dubbed the Feres doctrine on military personnel, and the prohibition of Active Duty service members from bringing suit against the U.S. Government, specifically for medical malpractice. Feres is the product of judicial activism and Congress' silence. As no less an authority than my favorite Supreme Court Justice, Antonin Scalia, said, quote, ``There is no justification for this Court to read exemptions into the act beyond those provided by Congress. If the act is to be altered, then it is a function for the same body that adopted it,'' unquote. The court overreached, and Congress' response is long overdue. Today, we have a panel to help inform us of the issues surrounding the Feres doctrine. Our first three witnesses are pained victims who have been aggrieved firsthand by the outdated judicial doctrine. I want to thank you all for being here. You are representing yourselves, your families, and countless others despite what you have lost and will lose. Your commitment to fixing this policy is admirable and greatly appreciated. Our first witness is Sergeant First Class Richard Stayskal, whose radiologic diagnostic test was misread at an Army treatment facility and who currently has stage 4 terminal cancer. Sergeant Stayskal, I want to take this moment to thank you in particular. Because of the malpractice you suffered, your time is numbered in days and weeks, not years and decades. I know you would rather spend this time that you have left with your family and loved ones closer to home, not here at Congress, but I am greatly indebted to you for doing so. You have moved me, by the conversation we had months ago, so much that I felt compelled to hold this hearing today. So I know you are here not because I invited you but because your commitment to your fellow service members runs so deep, your desire to achieve justice for them so profound, that you continue to look out for them as best as you can and as long as you can. And I promise you that we will all remember your commitment, your honor, and your sacrifice and that I will keep working on this to fix it as long as I am here. Our second witness is Ms. Alexis Witt, the widow of Air Force Staff Sergeant Dean Patrick Witt, who was hospitalized in 2003 for what should have been a routine appendectomy at Travis Air Force Base in Fairfield, California. Following surgery, a nurse administered a lethal dose of fentanyl, causing respiratory and cardiac arrest, and incorrectly inserted a breathing tube into his esophagus, depriving his brain of oxygen. Staff Sergeant Witt remained in a vegetative state for 3 months until Ms. Witt removed his feeding tube. Our third witness is Ms. Rebecca Lipe, a former judge advocate for the Air Force who now practices in the civilian sector, who, while deployed in Iraq, had to wear ill-fitting, MacGyvered body armor that caused her debilitating abdominal pain. Military physicians repeatedly misdiagnosed and mistreated her, making the problem worse and causing chronic pain and permanently damaging her reproductive system. These three witnesses represent the countless hundreds, if not thousands, of victims denied justice over the 69 years the Feres doctrine has been in place. I hope to learn more about the malpractice the three of you have suffered and how the Feres doctrine amplified the harm. The families of Feres victims, both here and around the country, suffer too. They lose loved ones in the prime of their lives and are left with a one-size-fits-all compensation system that cannot hope to adjust for the damage done in severe malpractice cases. When our service members suffer from medical malpractice, when doctors fail to perform or woefully misread tests, when nurses botch routine procedures, when clinicians ignore and disregard pain, service members deserve their day in court. When lives are disrupted, ruined, and cut short by negligence, service members deserve a chance to receive just compensation. We are not talking about special treatment. We are talking about giving service members the same rights as their spouses, Federal workers, and even prisoners when compensation schemes are insufficient. When administrative redress processes fail, service members should have their claims heard in the justice system under the Federal Tort Claims Act. And we are not talking about service members who, in Active Duty, are in combat. We are talking about service members who are here in the United States or elsewhere not in a combative role. In our country, we rightfully revere service members for their bravery and sacrifice. It is disrespectful and shameful that for 69 years, Congress has refused to give them the same rights as everyone else or just the same rights as the rest of their families. But this isn't just a matter of justice; it is a question of accountability. Because behind the shield of Feres, DOD's [Department of Defense's] health providers act with impunity. We have heard countless stories from service members of procedures, big and small, botched in ways that are always frustrating and occasionally catastrophic. Gauging the full extent of this problem is difficult, but ask any service member you meet or their family, and they will have a story. Allowing service members to sue the Department of Defense for medical malpractice will help root out this rot. There are few incentives better than the threat of legal action to push an organization to change its behavior. This would lead to better quality care for our service members and higher levels of readiness. We will also hear from two legal experts who have studied the Feres doctrine. We look forward to gaining a better understanding of the legal foundation for Feres and why it has remained in place for 69 years just because the Supreme Court decided to legislate and Congress has sat back idly. We would like our legal experts to share any recommendations on how the Feres doctrine may be changed in ways that respect the unique nature and needs of the U.S. military. The legal experts on our panel are Dr. Dwight Stirling, chief executive officer of the Center for Law and Military Policy, a think tank dedicated to strengthening the legal protections of those who serve the Nation in uniform. Dr. Stirling is also a Reserve JAG [Judge Advocate General] officer in the California National Guard and co-founder of Veterans Legal Institute. Also joining us is Mr. Paul Figley, professor and associate director of legal rhetoric, American University Washington College of Law, that has published on the defense of the Feres doctrine. Before hearing from our panel, let me offer Ranking Member Kelly an opportunity to make his opening remarks. [The opening statement of Ms. Speier can be found in the Appendix on page 37.] STATEMENT OF HON. TRENT KELLY, A REPRESENTATIVE FROM MISSISSIPPI, RANKING MEMBER, SUBCOMMITTEE ON MILITARY PERSONNEL Mr. Kelly. Thank you, Chairwoman Speier. I want to thank each of our witnesses for being here today. I particularly want to thank Sergeant First Class Stayskal, Ms. Witt, and Ms. Lipe, who graduated from the same law school as I did, for your service to our great Nation. I wish to extend my profound sympathy for what each of you has gone through and are going through. No one should have to experience what you have experienced. Our service members, who sacrifice so much, deserve the best medical care that we can provide, and we, as an institution, let you down. I am glad that you are able to tell your stories here today and bring public attention to this very important issue. But the unfortunate reality is that the Judiciary Committee, not the Armed Services Committee, has jurisdiction over this issue and should be holding this hearing instead of us. I encourage our colleagues on the Judiciary Committee to do so and to have an open debate on this issue that impacts our brave men and women who serve this great Nation. But even if the Feres doctrine is changed, we know it will not make you or the other victims of military medical malpractice whole. We know that nothing can take away the profound wrongs that have been done to you. Therefore, we must focus on preventing these mistakes from happening again. My primary concern is to make sure that the failures you experienced in the military medical health system do not happen to other service members. The quality of care in our Military Health System is something that is squarely within the jurisdiction of this committee. In reading through the written statements of Sergeant First Class Stayskal, Ms. Witt, and Ms. Lipe, it is clear that the medical malpractice in these cases was not isolated to just one doctor. For example, Sergeant First Class Stayskal visited multiple doctors and the ER [emergency room] on several occasions, and not one of those doctors correctly diagnosed his cancer. In Ms. Lipe's case, she was treated in a combat zone, then at Landstuhl, and then back in the United States before anyone found her source of pain. These repeated failures, which occurred at military medical treatment facilities all around the world, indicate systemic problems within the military healthcare system. Based on the language of the 2017 NDAA [National Defense Authorization Act], the Military Health System is currently undergoing the largest reform in a generation. This includes standardizing patient experience, improving quality of care, and increasing access to care--reforms that are essential to fixing the types of issues highlighted by your cases. However, there are aspects of the Defense Department's reform plan that deserve great scrutiny. The services are contemplating a reduction of up to 20 percent of uniformed medical personnel, the Defense Department is evaluating whether medical facilities should be closed down, and many service members and beneficiaries are concerned. I fear that these changes may damage the Military Health System and that these profound changes will happen without proper oversight from Congress. That is why I have asked for this subcommittee to hold a hearing on the status of military health reform. In addition, The Military Coalition, a consortium of organizations representing 5.5 million service members, veterans, their families, and survivors, recently wrote the subcommittee urging the committee to hold a hearing on military health reform. Madam Chairwoman, I ask that The Military Coalition's letter be made part of the record. Ms. Speier. Without objection. [The letter referred to was not available at the time of printing.] Mr. Kelly. I urge the subcommittee to have a hearing on military healthcare reform prior to the National Defense Authorization Act markup so that members can address these important issues. While I look forward to hearing from each of the witnesses today to discuss the Feres doctrine, I also want to learn more about your medical experiences and what we can do to make sure that these failures don't happen to any other service members. With the military healthcare reforms currently underway, we have a rare opportunity to fix many of the problems that you encountered. So I look forward to your testimony, and I thank you for discussing this very important subject. With that, Madam Chairwoman, I yield back. Ms. Speier. Thank you, Mr. Kelly. I ask unanimous consent to allow Members not on the subcommittee to participate in today's hearing and be allowed to ask questions after all subcommittee members have been recognized. Any objection? Mr. Kelly. Without objection. Ms. Speier. Each witness will have the opportunity to present his or her testimony, and each member will have an opportunity to question the witnesses for 5 minutes. We respectfully ask the witnesses to summarize their testimony in 5 minutes or less. Your written comments and statements will be made part of the hearing record. Also, we had hoped to have Professor Andy Popper of the American University Law School testify today. Though personal issues precluded his participation, I would like to ask unanimous consent to enter his article on this subject in the record. Mr. Kelly. Without objection. Ms. Speier. Without objection, so ordered. [The information referred to can be found in the Appendix on page 141.] Ms. Speier. With that, Sergeant First Class Stayskal, you will make your opening remarks. Thank you so much again for being here. STATEMENT OF SFC RICHARD STAYSKAL, USA, SPECIAL FORCES GREEN BERET Sergeant Stayskal. Chairwoman Speier, Ranking Member Kelly, and members of the subcommittee. I am grateful for your support, Chairwoman Speier, and thank you for the opportunity to appear here before you today in the subcommittee to present my story. I very much appreciate being invited to testify about the Feres doctrine. This is the first time I have ever been called to testify, and I wish it could have been under different circumstances, but, nonetheless, I feel this is an important issue to address. I feel this is a very important issue to the military community that requires congressional intervention to address and fix how this mistaken doctrine is used to strip hundreds of service members like myself and their families of the same rights that the rest of the citizens of our country have when it comes to medical malpractice. By way of introduction, I served as a Marine for 4 years and am currently serving as a Green Beret in the United States Army Special Forces, stationed at Fort Bragg, North Carolina. I have devoted my entire career to the military, with this June marking my 17th year of service. I first enlisted into the United States Marine Corps in 2001 and served as a machine gunner and a scout sniper for 4 years. During my 2004 tour to Al Anbar province, Ramadi, Iraq, I was critically wounded in action by heavy insurgent sniper fire. Following my recovery, I was honorably discharged from the Marine Corps. By 2008, I had joined the Army and become special forces. I was assigned to the 10th Special Forces Group, Fort Carson, Colorado, and later assigned 1st Special Warfare Training Group. I have been on multiple deployments throughout areas of responsibility in support of national interests during global war on terrorism. I have held numerous positions throughout my military career. I was selected by the Army Special Forces Group to attend special forces underwater school Combat Dive Qualification Course, CDQC. Because of my previous gunshot wound, it was mandatory that I could not attend this school without having a CT [computerized tomography] scan done of my lungs to ensure the safety of myself and other divers within the course. When the imaging was done, my physical went forward, and I was cleared in January. A civilian had reviewed my scans and cleared me to go, and I went down to school. Until about 6 months later, I found out that a Womack Army doctor failed to identify an abnormally (over 1.5 centimeter) large tumor located in the upper right lobe of my lung. While attending dive school around the end of March 2017, I was experiencing difficulty breathing, and by April 2017 I had begun noticing signs of declining health--something I had never experienced before in my career or life. I was wheezing, coughing, had difficulty breathing. Anytime I would lay flat on my back, I felt like I was suffocating, and the weight on my chest was--it was unbearable. I had also begun coughing up a bit of blood at this time. Typically, I am not one to complain. My training doesn't allow it. We continue to work without complaint. I started to express my concerns to my wife, Megan, and my coworkers. Finally, I had enough. I had to admit myself for help. I went down to the SWCS [Special Warfare Center and School] clinic to seek treatment, and they called an ambulance and sent me down to the Womack Army Hospital. As I was wheeled into Womack Army Hospital, I went straight through the triage room and went out to the waiting room, where I was placed to wait with everybody else. By the time I saw the nurse and she had taken my vitals and I told her my symptoms and signs, she pretty much told me there was no way I could be in serious pain or any kind of discomfort due to my age and my condition of my job. She pretty much just disregarded it. By the time I went back and I saw the ER doctor, he had ordered an x-ray, reviewed the x-ray, and said it was probably walking pneumonia. So he did a couple breathing treatments and sent me on my way. Later that week, things continued to progress. By 1 week later, May 22nd, I was back into the ER. This time, I was calling my wife, I called TRICARE, I called the Army hospital; I begged and begged and begged for somebody to see me. I knew something was wrong at this point. My vision was going out, I couldn't concentrate, and I couldn't see. My commander, not wanting me to go back to Womack Army Hospital and suffer the same thing, put me in my car and had somebody drive me out to meet my wife in town. By the time I got out there, I was practically unconscious. My wife picked me up, along with a friend, put me in a wheelchair, and they wheeled me inside. While I was waiting to be seen, I completely passed out at this time. They took me in the back, where I was told a nurse did a sternum rub on my chest to bring me back and wake me up. From there, I did more treatments, and the ER discharged me with potential walking pneumonia and gave me prednisone. They didn't find anything either. It was also stated that when I left Fort Bragg Army Womack Hospital that something had been seen and it was noted, but they didn't tell me what it was or what condition it was, that I was just to wait to follow up. By the time I had been seen out in town, 6 months had passed by. The tumor had doubled in size; 2.8 by 2.2 centimeters was present on my upper right lung, and the CT scan showed a follow-up that should have been scheduled for me. Like I said, nobody ever told me. It wasn't until finally my commander went down to the hospital and demanded that I either be seen or released to go off-post. At that time, the officer in charge said it was fine, I could go off-post. He released me, but, yet again, it took within the system several weeks for me to get off-post and be seen. Once I was off-post and seen, immediately the doctor called me within a matter of a day, told me I needed more scans and I needed to bring everything in that I had. I brought that all in. Within 2 more days, I was seen, did a breathing treatment test. And then the last question he asked me, he says, have you been coughing up blood? I said, yes, I have. He says, you need to go downstairs immediately and do a scan. He called me within the next day and said, if I could have you in here tomorrow for a test, I would, but I have to wait until the following week. So the following week I went in, and I had a biopsy done on my lung. And when I awoke, I was woken up to my wife crying and learning that I had, at the time, stage 3A lung cancer. This life-changing news that could have been addressed nearly 6 months earlier while the cancer was still contained to one area of my lung--sorry--is inexcusable. Later, around Christmas of 2017, I began to cough up more, in tremendous amounts of pain. By the beginning of January 2018, I had to go to the ER, where I was seen again for exhibiting difficulties breathing. This was an overall physically painful time due to my cancer spreading throughout my body. I eventually did a PET [positron emission tomography] scan, and the PET scan revealed that my cancer had been metastatic and had spread. It now was in the left side of my neck in my lymph nodes, my spleen, liver, ilium crest, spine, and right hip joint. Beginning on January 22, 2018, I was diagnosed stage 4, terminal. The failure of the military doctor's gross negligence and the failure to detect my cancer when it was first noted on the CT scan done on me in January of 2017 is a mistake that allowed an aggressive tumor to double in size and rob me and my family of my life without any recourse due to a 1950s Supreme Court court case that created the Feres doctrine. Because of all that has taken place, I am no longer able to complete the Warrant Officer Course which I was selected for, and I am now currently being separated due to a medical discharge. I have endured countless CT scans, MRIs [magnetic resonance imagings], PET scans, radiation, chemo, spleen biopsy, lung biopsy, as well as surgery to remove my upper right lobe. I have had countless other procedures, and no end in sight. Lastly, I want to say that this does affect me, obviously, but my children are definitely the true victims, along with my wife. The hardest thing I have to do is explain to my children when they ask me, this doesn't make sense, how is this happening, and I have no good answer to give them. And I say, that is why I am coming up here to help convince these folks in Congress to change this. This doctrine has effectively barred hundreds of service members and their families any chance to be made whole for receiving negligent medical care that is given by the government provider when service members are on Active Duty. Regardless of whether injury was a result of combat service or deployment, the doctrine has been utilized by branches of the military to shield negligent medical care given by military providers. This is medical care in which there is no element of military judgment. In truth, the only difference between a military provider and a civilian provider is the military provider wore fatigues to work that day and his or her patients do not have a choice accepting their services. This is why I am up here today, to call upon you folks to hear our cases and hopefully make a change within Congress in legislation. I want to thank again my attorneys, Natalie Khawam and Daniel Maharaj, and again my family, and again Chairwoman Speier and Ranking Member Kelly for holding this and hearing my story. [The prepared statement of Sergeant Stayskal can be found in the Appendix on page 40.] Ms. Speier. Sergeant Stayskal, that was profound testimony. Thank you so very much. Ms. Witt. STATEMENT OF ALEXIS WITT, WIDOW OF SSGT DEAN WITT AND ADVOCATE FOR FERES DOCTRINE REFORM Ms. Witt. Thank you, Chairwoman Speier, and to the members of the subcommittee for the opportunity to speak today. As you know and as you mentioned earlier, in October 2003, my husband, Staff Sergeant Dean Witt, underwent a routine appendectomy. The nurse anesthetist was faulted for having administered a lethal dose of fentanyl, resulting in respiratory and cardiac arrest. She failed to call a code blue, used pediatric equipment for resuscitation, and misdirected a breathing tube. Each mistake delayed critical seconds, and Dean suffered severe brain damage and remained in a vegetative state until I removed his feeding tube 3 months later. I later filed a wrongful death suit, but my case was dismissed on the grounds of the Feres doctrine. Sixty-nine years ago, the Feres doctrine was wrongly decided by the Supreme Court, because it leads to not only medical malpractice but also the abuse of power, mistreatment of survivors, lack of transparency, and lack of accountability. After the malpractice incident and while my husband was still in the intensive care unit, I met with two JAG officers, a death casualty officer, Dean's major and first sergeant to discuss permanently retiring Dean. I was outnumbered, I was alone, and I was without legal representation. I knew signing these documents was serious, but I didn't understand all the implication or consequences it would impose. In my distress, I told the JAG officers I preferred to wait. I was threatened with the removal of my medical benefits and Dean's pay frozen until I signed these documents. Later, I would learn that the rush to have Dean retired came down to eligibility for survivors' benefits, as Active Duty death benefits differ from retired benefits. I was also told a formal investigation would take place and would result in changes to safety protocols within the hospital to prevent another tragedy from occurring. When I asked about the details of these safety measures and for a copy of the investigation, I was told that the information was protected by title 10 of the United States Code, would not be made available to me or to anybody in the public, and I would never fully know what happened to my husband in the OR [operating room]. The nurse responsible for my husband's death was also responsible for the death of another airman just 1 year prior. A colleague had stated she was considered the weakest link in their department. Despite her performance being merited as unsatisfactory, no preventive measures were taken to curtail her advancement, and she went on to kill two patients. If the appropriate action had been taken on this nurse during her first lethal negligent episode, Dean would still be alive today. Before I end my time today, I would like to discuss one last topic that is delicate in nature. And I don't want to come across as indelicate, but it is a matter worth mentioning because it affects all survivors that are affected by the Feres doctrine. It comes down to survivors' benefits. They are often cited by the opposition as the reason not to move forward with the Feres reform. Military law expert Eugene Fidell has quoted survivor benefits as being robust, yet they do not take into account pain and suffering. These benefits also come with restriction, whereas an award settlement would not have such restrictions. To name a few of these restrictions and what I experience each year, I have to sign a certificate of eligibility form proclaiming that I have not married in the past year. I have to do this twice a year, for each of my dependents. SBP [Survivor Benefit Plan] and the DIC [Dependency and Indemnity Compensation] offset cut 65,000 spouses out of nearly $12,000 a year in compensation. The SBP is an insurance annuity, and DIC is a VA [Veterans Affairs] benefit, but they count against one another when they shouldn't. If the survivor remarries, he or she forfeits the VA benefit. There are also earned income restrictions. With the DIC, I cannot take a job that would go over $8,000 a year. The Department of Defense survivors' benefit is taxable. The SBP is treated the same as a trust or estate, which means minor children can be taxed at a rate as high as 37 percent. The Department of Veteran Affairs' Dependency and Indemnity Compensation is not taxable. With an award settlement, the IRS [Internal Revenue Service] does not tax award settlements for personal injury cases or wrongful death cases. I hope my experience with the Feres doctrine has served a higher purpose and gives you a well-rounded view of its effects on our military and their dependents. And thank you for holding this hearing and thank you for listening. [The prepared statement of Ms. Witt can be found in the Appendix on page 51.] Ms. Speier. Thank you so much for your testimony. I think we have struggled for a long time on the issue of widowhood and the compensation issue, and it is one that has to be fixed. But you have raised some other additional issues that we will get to during the rest of the hearing. Thank you so much. Ms. Lipe. STATEMENT OF REBECCA LIPE, J.D., FORMER AIR FORCE JUDGE ADVOCATE AND ASSOCIATE ATTORNEY, STEPTOE & JOHNSON, LLP, SERVICE WOMEN'S ACTION NETWORK Ms. Lipe. Madam Chairwoman, Ranking Member Kelly, honorable members of the subcommittee, my name is Rebecca Lipe, and today I have the unique privilege to speak to you as a disabled Air Force veteran and a representative of the Service Women's Action Network. My story begins in 2011, when I deployed to the Combined Joint Special Operations Task Force in Balad, Iraq. In my role as the deputy staff judge advocate, I oversaw six subordinate commands and their respective JAGs. These duties required me to travel around the country in full gear, which included the standard-issue ballistic vest. Now, the ballistic vests are not designed to fit a woman's body. In order for the gear to protect my vital organs, I actually had to remove the side panels, and I had to place foam inserts on the shoulders in order to remove some of the slack. I also was required to overtighten the gear around my waist so that it would remain in place. Ironically, this made the gear less protective. Five and a half months into my deployment, I began having acute and debilitating pain in my abdomen. At the same time, we were withdrawing from Iraq--excuse me--so there were limited resources at the medical facility in Balad to actually address my pain. However, instead of conducting an actual, thorough exam, they first accused me of having an extramarital affair, which was blatantly false, told me I must have had STDs [sexually transmitted diseases], and then--excuse me. Ms. Speier. Ms. Lipe, take your time. Take a little swig of water if you would like. Ms. Lipe. And then they chalked up my pain to normal women's problems. From Iraq, I was medically evacuated to Landstuhl, Germany. Landstuhl is one of the most premier hospitals in the military's arsenal. Even with the extensive resources available at Landstuhl, the doctors determined without any objective evidence that I had pelvic inflammatory disease, which is considered a normal, like, typical woman's problem. They also, without any evidence, treated me on antibiotics for malaria, which I also did not have, and decided to medically evacuate me all the way back to Hurlburt Field. From there, the mistakes continued for more than a year. The medical providers at Eglin Air Force Base were certain it was a female reproductive issue and performed two random, unnecessary surgeries on me and prescribed medicine that placed me into temporary menopause at 27 years old. This caused catastrophic hormonal depletions, organ and vaginal tissue atrophy, prevented sexual intimacy of any kind with my husband, and caused severe levels of depression to the point I was suicidal. Throughout this trauma, I was also accused by military medical professionals of malingering and making up the debilitating pain. Thankfully, though, after a year and a diligent review of my medical records by one doctor at Moody Air Force Base, my care changed. He was appalled at the previous treatment I received at the hands of the military and referred me to a civilian reproductive endocrinologist and a general surgeon. These two doctors immediately and correctly diagnosed me with sports herniation as a result of wearing the ballistic gear. The civilian doctors subsequently corrected eight areas of my abdominal wall and attempted to reverse the effects of the unnecessary medical treatment I received at the hands of the military medical providers, but the damage was already done. I now deal with chronic abdominal pain and complications due to that medical treatment. Further, my husband and I were completely unable to have children except through in vitro fertilization [IVF]. To date, we have undergone seven rounds of IVF at the personal cost of over $60,000. Sadly, through much of this process I continued to receive substandard care at the hands of the military. During my first pregnancy, the doctors at Andrews Air Force Base misdiagnosed an ectopic pregnancy, resulting in an emergency surgery and the loss of my fallopian tube. During our fifth round of IVF, I suffered a miscarriage and had to wait 4 days for a D&C [dilation and curettage] at Walter Reed, which should have been an emergency surgery. And then, after the surgery, the hospital subsequently lost the remains of our baby. During our sixth round of IVF, after I had separated from the Air Force and switched exclusively to civilian providers, I received a level of care I had never received while on Active Duty and was able to deliver a healthy baby girl in July 2017. This fall, my husband and I attempted our last round of IVF, but I experienced potentially fatal complications, and as a result, we can no longer have children. The compound effect of this revelation along with the years of medical maltreatment and physical pain took its toll, causing me to seek hospitalization once again. Now I sit before you, 10 abdominal surgeries later, as a broken but not defeated advocate for service members. Even as a JAG and experienced advocate, I had to fight hard to receive appropriate medical care from the military system. The majority of other military members are not in the same position I am, especially our enlisted members, to be able to be an advocate. Additionally, service women are still being issued ill- fitting gear when the technology is out there to outfit every single female with the right gear if Congress would only appropriate the funds to do so. Members of the committee, as our champions and advocates, you can and must ensure that service members have access to and receive appropriate care from trained healthcare professionals. This includes providing the full range of women's health services in light of the growing number of female service military members defending our country. You must also ensure that the military medical providers are held responsible for their incompetent actions. Most importantly, you can ensure that service members who have suffered from medical malpractice are able to be compensated under the Federal Tort Claims Act for their injuries. No service member should have to fight as hard as I did for their health with the military itself. We have the greatest military in the world, and our medical care should be no different. Thank you for the opportunity to offer my testimony, and I look forward to answering any questions you have. [The prepared statement of Ms. Lipe can be found in the Appendix on page 62.] Ms. Speier. Ms. Lipe, thank you for your service to our country and for your riveting testimony. Dr. Stirling. STATEMENT OF DWIGHT STIRLING, J.D., LL.M., CHIEF EXECUTIVE OFFICER, CENTER FOR LAW AND MILITARY POLICY Dr. Stirling. Honorable Chairwoman Speier, Ranking Member Kelly---- Ms. Speier. Could you put the microphone closer to you? Dr. Stirling. Yes--and members of the committee, I am honored to be here today to address this important topic. I am the CEO [chief executive officer] of the Center for Law and Military Policy, a nonprofit think tank. I am also a law professor at the USC [University of Southern California] Gould School of Law and a JAG officer in the Army Guard. I recently completed a doctoral dissertation on the Feres doctrine. My testimony today is a product of having read every case and every article that has ever been written about the Feres doctrine and my nearly two decades as a military lawyer. The Feres doctrine is the most disparaged and discredited legal doctrine in modern history. The condemnation has been constant and vociferous and nearly universal. The critiques that are the most hard-hitting have been made by the conservatives, in particular the late Justice Scalia and Professor Jonathan Turley. To Justice Scalia, the doctrine was simply judicial legislation. The plain language of the FTCA [Federal Tort Claims Act] includes the personnel who are in the military, yet the Supreme Court had rewritten the act to exclude them. To him, this was activism at its worst. He also condemned the fact that there was a double standard at the heart of the doctrine. It only applies to members of the military, not to their dependents or to people who are retirees. Within the military healthcare system, more than three- fourths are civilians. They are the dependents and the retirees. Yet, when a doctor does a surgery and leaves a tool in their stomach afterwards, they can sue. Or if any of these events that we heard here by my colleagues had taken place to a civilian, to a dependent, they can sue. But when it happens to a service member, they can't. If civil liability was so detrimental to the system, why isn't it banned? Why doesn't the ban then apply to everybody? Instead, it only applies to the few, to the less than 20 percent who are actually wearing a uniform. Professor Turley, for his part, said that the way the doctrine operates reduces the quality of care. Applying a cost- benefit analysis, government officials overuse folks who are military doctors, who can't be sued, and they will underuse the civilians who are the specialists, who can be sued. They capitalize on a loophole, and they limit the access to the specialists who are civilians. As a consequence, according to Turley, we are putting our service members' lives at risk. This particularly affects the young, the 18- to 22-year- olds, who are forced to receive almost all their care at a base hospital. I, as a major, and folks who are senior officers can often get off-post to see a civilian, but the junior enlisted can't. They don't have that kind of pull. The upshot of all of this is concerning. While our policy makers are sending our military personnel to fight and die abroad, they fail to protect them at home. Let's keep this in mind: Even those in prison can sue when a doctor makes a mistake. We are giving more rights and protections to those in prison than to those who wear our uniform. I keep having the question, does this reflect our values? I have a hard time in responding to that in the affirmative. Okay. Thank you. [The prepared statement of Dr. Stirling can be found in the Appendix on page 73.] Ms. Speier. Thank you, Dr. Stirling. Mr. Figley. STATEMENT OF PAUL F. FIGLEY, J.D., PROFESSOR OF LEGAL RHETORIC, AMERICAN UNIVERSITY WASHINGTON COLLEGE OF LAW Mr. Figley. Madam Chair, Mr. Ranking Member, members of the committee, by way of experience, I spent three decades representing the United States in the Civil Division of Department of Justice in Federal Tort Claims Act litigation. For the last 15 of those years, I was second in command in the office responsible for most of the tort litigation of the government. For over a decade now, I have been in academia, where I teach torts and where I write about sovereign immunity, the FTCA, and the Judgment Fund. At the outset, we can all agree that government negligence or malpractice does cause real injuries and can have a tragic impact on the lives of service members and their families. It is understandable that such people are frustrated when they perceive that they or their loved ones are being treated unfairly. From the perspective of one injured service member or one family, the remedy may seem obvious: allow the injured service member to sue in tort. From the perspective of fostering the long-term success of a critically important institution, the United States military, that remedy is mistaken. Simply put, Congress should not alter the Feres doctrine. Doing so would disrupt the vital and special relationship between the government and its service members. That relationship has roots in the military's unique disciplinary system, its special and exclusive system of military justice, and its comprehensive compensation system. The military compensation is similar to State workers' compensation programs in that it provides a prompt, fixed, administrative remedy without a showing of employer negligence or the time, expense, and emotional burdens of litigation. The military system is more encompassing than workers' compensation laws because it applies to injuries arising during a service member's period of service, not just those arising in the course of employment at the workplace. Its benefits are substantially broader than those of State workers' compensation laws and include programs ranging from education to housing to medical home improvements, lifelong care, and sexual trauma. The VA booklet describing benefits fills 70 pages. If Congress overturns the Feres doctrine, attorneys for injured service members will litigate whether someone in the government wrongfully caused those injuries. And as the Supreme Court has repeatedly recognized, the unique relationship between the United States and its service members would be undermined if exposed to our adversarial tort system. One key part of that relationship is the military's obligation to take care of its own and to treat similarly situated service members equally. Similarly situated service members cannot be treated equally if Congress overturns Feres. If three service member amputees share a hospital ward, one having lost a leg in combat, one suffering the same loss in a tank accident in France, and one because of malpractice by a military doctor in New York, each will have the full panoply of military benefits. The two who suffered their loss in combat or overseas would be barred from suing by the FTCA's exceptions for claims arising in combatant activities or foreign countries. An FTCA suit by the one injured in New York would likely recover a million-dollar judgment. The other two service members would know it and may well feel unfairly treated. Such feelings undermine military morale and cohesion. This is not an idle concern. A key lesson of the September 11th compensation fund is that providing different, individualized awards to members of a group who have suffered a similar loss can cause frustration and ill will. As the report of that fund's special master explained, ``There are serious problems posed by a statutory approach mandating individualized awards for each eligible claimant. The statutory mandate of tailored awards fuel divisiveness among claimants and undercut the very cohesion and united national response reflected in the act. The fireman's widow would complain, `Why am I receiving less money than the stockbroker's widow? My husband died a hero. Why are you demeaning the value of his life?' '' Presidents Truman and Eisenhower understood this when they vetoed private bills for the benefit of single service members. President Eisenhower explained, quote, ``Uniformity and equality of treatment to all who are similarly situated must be the steadfast rule if the Federal programs for veterans and their dependents are to be operated successfully.'' For these reasons, Congress should not alter the Feres doctrine. [The prepared statement of Mr. Figley can be found in the Appendix on page 114.] Ms. Speier. All right. Thank you all for your testimony. Let me start with you, Mr. Figley. Do you think allowing service members to sue the government for medical malpractice in a noncombat setting would create a worrisome number of lawsuits that you might characterize as frivolous? Mr. Figley. No. I don't believe so. Ms. Speier. Okay. So that would not be an issue. You also referenced the trust relationship that exists. And there is a special kind of trust that exists between the military leadership and service members and their families. There is this trust in part because there is a sense that we are family and that we will take care of you. I want to ask those of you who have suffered the losses and the medical malpractice if you feel that the DOD's subsequent response has violated that relationship of trust. Sergeant Stayskal. Sergeant Stayskal. I believe it violates the trust completely. I mean, you know, when I signed up to do my job, I was told: This is your job. You will do this job. You will do it to the best of your abilities, no questions asked. Well, I believe that when the DOD said that they--whoever-- they said that they would provide me adequate medical care to a standard, and they failed that portion. So, therefore, my trust is completely broken with them, not all of them, but the ones--but then it goes back to, well, which one is it? Who knows now? They are blended in, and they disappear within the system. So the trust is lost completely there. So I don't--I don't---- Ms. Speier. All right. Ms. Witt. Ms. Witt. I have to agree with Sergeant Stayskal. In my particular situation, because of transparency issues, even down to making medical choices for my husband at that time, I was not, first, aware that he went so long without oxygen. I was only told that it was a couple of minutes and that they were just observing him until I actually arrived on the base and saw the state that he was in. He was in a medically induced coma, so I could not tell, like, how severe his brain damage was at that time. Had I known, I probably would not have had him suffer in his hospital room for 3 months. I probably would have taken him off life support at that time, which was a ventilation, and he probably would have been able to at least have donated his organs. And that affects, like, 10 other people in the world that were probably waiting on those organs. So that trust right there was lost because I couldn't even trust the medical providers who were providing him with care. Ms. Speier. You know, Ms. Witt, we have very similar experiences. My first husband was on life support, and that is exactly what I was concerned about, whether or not I would be able to donate his organs. So I totally understand what you are going through. Ms. Lipe, your comments? Ms. Lipe. I have completely lost faith in the DOD to be able to take care of me. I still am actually a Navy spouse. My husband is still serving Active Duty in the Navy. And so, therefore, both myself and my daughter are entitled to TRICARE benefits and could receive all of our care on base for limited cost. Instead, I pay an exorbitant amount of money to pay for my private insurance with my current employer because I don't trust them. I will not let them touch me or my daughter because I no longer trust that they can take care of us appropriately. Ms. Speier. Dr. Stirling, you know, those who are proponents of the Feres doctrine--and, certainly, Mr. Figley made mention of this in his testimony--suggest that depriving service members of an ability to sue is a fair trade in the circumstances, given the generosity and comprehensiveness of the military workers' comp scheme. Why do you think enabling service members to take legal action in malpractice cases is necessary despite the generosity of the scheme? Dr. Stirling. Because, Chairwoman, it is simply not the case. This idea that VA disability is a substitute for a lawsuit in the case of malpractice has been exposed as a fallacy by every scholar that I have ever read except for Mr. Figley. He is in the minority. I think he is the only one who has made that kind of a contention. And the reason is this. When you apply for VA disability, you have to show that there was a cause. You have to show that there was some kind of a military act that led to the injury that you are claiming has occurred. Well, in malpractice, you can't do that, because all the evidence of the cause is--that is the negligence. You can't get to the negligence because you can't file a lawsuit. So how can you show, when you are submitting a VA disability claim, that because of the appendectomy, you know, now I don't have any feeling within my fingers? It is because of the mistake that I lost the feeling. I don't have evidence of the mistake because I can't get to those documents. I can't sue. And, as we have heard, when I then--you know, if I am the patient and I am adversarial to the DOD, they shut down the information. So what happens? I have seen it time and time again as a veteran advocate. When you are hurt due to malpractice and you file a claim, the claim is denied. So you don't get that claim. That is a fallacy, and it should be rejected. And it has been by everyone except for my colleague, by Mr. Figley. Ms. Speier. Ms. Lipe, you referenced a traumatic experience in terms of gynecological services within the military. And it is an issue that I have been concerned about for some time, because I worry that there aren't enough sophisticated medical professionals with gynecological training in the military. I just toured a number of bases over the recess, and, talking to spouses, I heard that over and over again, that they don't diagnose, you know, cysts, for instance. What do you think we should do in order to make sure that service members who are women, who are going to need gynecological services, can get the kind of care they deserve? Ms. Lipe. I think especially given the lack of service, either increase the amount of the service providers who have those specialty skills in the military or allow those service members and the spouses, in certain circumstances, to go off- base and seek out civilian specialty. Because, for example, like, a reproductive endocrinologist, there are very few of them in the military. If they are not going to have one--if you are at Altus Air Force Base, they are not going to have an endocrinologist there. They should be able to seek out a civilian provider who has that. So I think it is allowing greater access to the civilian sector, which will also improve the standard of care and it will allow the most up-to-date care possible. Ms. Speier. Thank you. Sergeant Stayskal, in our conversation, I would just like some clarification. I was under the impression that when you went in for your initial scan before going to dive school that they actually noted on the results that you had a lesion and that you should be referred, and the powers that be just never followed up. Was that my error in my recollection? Sergeant Stayskal. Yes, ma'am. It was seen--or it was missed--it was missed in the beginning but noted the--they noted the second--the first time I went to the ER, they noted that it was actually seen on the first scans, and nobody ever told me. They never followed up. When I was discharged from the ER also, the doctor said, there is something there, we have seen something, but we are not sure of what it is, so you will have to go see a specialist. Ms. Speier. So the first scan actually did detect the error. It just wasn't--you weren't informed, and you weren't referred. And it wasn't until your second visit, which was then to the ER, that they said that there was something on your scan. Sergeant Stayskal. Yes, ma'am. Ms. Speier. And then were you referred? Sergeant Stayskal. Then I was referred, but by the time I had heard from pulmonology, I had an appointment that was about 30 days out before they would even talk to me. And that was what I was fighting to call back and say, hey, I need to be seen there. And they said, well, you have to be over a certain amount of days before you can be seen off-post, and new patients are not priority; existing patients are priorities. So that was where I had to keep waiting. But, again, even once you are referred off-post, you have to wait for the specialty referral to go through the system, and that has to go to the provider out in town. Then they have to call you and schedule an appointment. And by that time, about 6 weeks had gone by, again, from my first ER trip to where it had, from that point, spread from my lung over. And that was when I started coughing up blood profusely, I mean, to the point, when I was sleeping, I mean, it felt like I was being waterboarded. I couldn't breathe. I felt like I was drowning constantly. Ms. Speier. Thank you. Dr. Stirling, in your dissertation, you reference that two- thirds of those who are provided services at military hospitals are actually dependents. Is---- Dr. Stirling. Yes. Ms. Speier [continuing]. That correct? And that being the case, you would think that we should prioritize our service members in terms of getting services. But it appears that these facilities are providing services, first and foremost, to the spouses and the dependents. So, in Sergeant Stayskal's situation, he had to wait because there were all those other appointments before him of dependents. Is that correct? Dr. Stirling. Yes. Yes. But what is, I think, you know, particularly a problem is this idea that if we allow those hurt through malpractice to bring a lawsuit that somehow that is going to cause a dissension within the troops. And I love when that kind of claim is made by someone who didn't serve. Because I have served, and I know that that kind of claim is ridiculous. In fact, you know, it plays upon the worst kind of ideas, because what it does is it takes this idea that--we all are thankful for the infantry. Without the infantry, we wouldn't, you know, be here. They are the ones out in the field. And when they are hurt, it is important. But it is also important when a service member is hurt through the malpractice of a doctor. So the idea isn't which injury is more important or what one service member feels about another. It is, where is liability, you know? It is, where should we have civil liability? You know, there is no one--and I am at the top of the list--who wants there to be liability in combat. That is why our Congress and the FTCA said this doesn't apply to combat. That is why the bill that is in front of the committee doesn't apply to combat. No one wants a commander concerned about a suit on the battlefield. Nobody wants that. But what we do want is a doctor to be concerned. And so, you know, I ask, you know, how do we know that we want our doctors to be concerned? Because in every other aspect of our healthcare system, if a doctor is incompetent, he can be sued. If we don't like the idea of liability, you know, why do we have it everywhere else except for the military in the context of medical malpractice? It exists everywhere else except for one place, for the 1 percent who are fighting and dying for us. Is it the right kind of a policy to, you know, have their doctors, the ones who are fighting and dying, you know, not concerned about a lawsuit but every other doctor, to include the ones that do work on each of the Members here--you know, they have liability, and they do a good job because of that. Ms. Speier. Thank you. Ranking Member Kelly. Mr. Kelly. Thank each of you again. And it was powerful and moving testimony, and I appreciate that. Sergeant First Class Stayskal, you know, I want to reiterate again, it is not--the problem with this is we are talking about the Feres doctrine and we are in the wrong committee. Ms. Speier. Well---- Mr. Kelly. We are talking about differences between equity and law and equity--or cases of equity and cases of law, dicta versus real law. And so I hope the Judiciary Committee is listening to this, because these are very, very real discussions that need to be had in a committee that can actually do something about it. We are doing something here, and I thank the chairwoman for bringing this. We are doing something because we are highlighting their need to address this. But the reality is-- but--so, Sergeant First Class Stayskal, I want to focus on what we can do in this committee on military personnel to help other soldiers from doing what you have--the wrongs that you have been done. So did you report any of these incidents to DOD? And what actions were taken to investigate the failures of the medical treatment? Sergeant Stayskal. So, once my wife and I began reading back through the notes, the doctors' notes and everything, you know, it became very evident that something was wrong. Even when I finally got to see my civilian provider out in town, he was actually the first one to go, ``Why weren't you seen in January? There is clearly a mass there.'' And that was what sparked us. And my wife just started reading and reading, and before we knew it, it didn't make sense. At that point, I actually scheduled a meeting with the OIC [officer in charge] of the hospital at the time at Womack. I invited my chain of command to go down there with me. They went with me. I am not going to speculate where the commander was, but he just came off of leave at the time. When I went into his office, explained everything that had happened to him, I was met with, ``Things do happen.'' From there, I--pretty much, I mean, there was a lot of back and forth, but there was no real answer on--there was nothing they could do, you know. So I really got no feedback after that. That was pretty much the answer I got, sir. Mr. Kelly. I hope that you will let DOD--and hopefully some of those guys are listening today, but I hope that you will file a complaint so that we can do some systemic things that maybe can keep someone else from doing this in the future. And I thank you for your service both in the Marine Corps-- and I actually was in the same area but a little bit after when you were there. And so thank you for your service. Ms. Lipe, you and I met in my office earlier today. And one of the stated goals of the 2017 NDAA Military Health System reform is to standardize patient experiences, that service members receive excellent care regardless of where they are seen. And you have covered a little bit of those, but tell me the differences in where you have received care. And you don't have any confidence in the military healthcare system now to care for you and your daughter. Is that correct? Ms. Lipe. Yes, sir. I was seen at Landstuhl, Eglin Air Force Base, Hurlburt Field, Moody Air Force Base. I have seen a number of--and Walter Reed. Two, Walter Reed and Landstuhl, are one of the most premier hospitals that the military has, and I have received medical malpractice in each of those locations. So it doesn't give me faith that I am going to be listened to, especially when it got to the point of the medical doctors telling me I was making it up and that it was in my head. That is not treating you. So I had already had the mental health issues because of the hormonal depletion, but when you have a medical provider just telling you you are making it up, you lose faith in their ability to even listen or treat you. So now I see only civilian providers and my daughter sees only civilian providers. My husband, unfortunately, because he is still Active Duty, doesn't have the option to see anything but military providers, and that terrifies me. Mr. Kelly. And I think we talked about some of those things, things that are within--that we can fix on this committee, or this subcommittee. And we talked about the body- armor issue. Ms. Lipe. Yes, sir. Mr. Kelly. And those are the things we can fix, because there is the root cause of this. And we still haven't fixed that problem. And we also talked about the number of female--not female physicians--physicians who are capable of treating uniquely female problems. And do you feel there are enough, or do you think there are things that our military healthcare system could do so that we can better take care of our females in service? Ms. Lipe. I don't believe there are enough. For example, at Walter Reed, you have--the GYNs [gynecologists] are dual-hatted in both the IVF clinic as well as the GYN clinic. So that is one of the reasons why Walter Reed can only provide so many IVF treatment cycles per year. They are dual-hatted and trying to serve multi purposes, where you need to have specialized care where they can focus on specific areas. If you are going to do in vitro, focus on just in vitro. If you are going to be a GYN, make sure they are the best GYNs available. And make sure there are enough of them so you are not having to see, necessarily, a nurse practitioner; you can see an actual GYN. We need more specialists, and we need them to account for the amount of women that are in the military. And in regards to the gear, the technology is already there. It just is outfitting it. We can look at the number of women serving in the military, and we can count what the gear costs and figure out what the appropriate level of appropriations is. Mr. Kelly. Would you agree with me that, depending on the location that you are, what you need is the best health care you can get, whether that is military treatment or outside treatment? Someplaces that is available, sometimes it is better in the military, sometimes it is better on the civilian world, depending on where you are located. But would you agree we need to look at how we make sure we have the right assets, the right people with the right skills in the right place at the right time? Ms. Lipe. Absolutely. That is the only reason that I was referred to the reproductive endocrinologist who got me healthy. I had to drive 2 hours each way to see him, but it was worth it. And it was thankfully from one doctor at Moody Air Force Base who understood that he did not have the experience and knowledge to treat me, and he got me to the doctor who could. Mr. Kelly. And Ms. Witt, I understand that you have advocated for changes to patient safety when administering anesthesia. What changes would you make to the military medical practices regarding the use of anesthesia? Ms. Witt. That is a complicated question, because I am not a medical expert, and I haven't--even though I am in school right now for prerequisites for nursing, I don't plan on going into anesthesia as a nurse. I have advocated with medical boards to--I don't necessarily think that nurses should be doing anesthesia. I think it should just be an anesthesiologist, that they are more well-rounded in health care. I believe that they have about 50,000 more clinical hours and experience and additional schooling in order to become an anesthesiologist. Therefore, if something happens, you have critical seconds to apply medical care to someone, to get an airway opened up again if it has become closed off. And a nurse anesthetist cannot open up an emergency trach [tracheotomy] to do that. Only an anesthesiologist would be able to do that. Mr. Kelly. I thank each of you three again for your testimony here today. And I am sorry for the travesties that each of you have deserved. And I want to make that better for our soldiers, sailors, airmen, and Marines and our DOD people and their spouses in the future. So thank you for your service, and I am sorry from the bottom of my heart. I just want each of you to know it never should have happened. But let's please do what we can to keep it from happening again. Thank you. And I yield back. Ms. Speier. Thank you. Let me clarify for everyone that this committee has full jurisdiction over the quality of medical health care in the military, and that is why we are having this hearing. I think it is very informative to all of us. And the amendment to the Federal Tort Claims Act is an amendment that I am introducing as a bill later today. And it will be named after Sergeant Stayskal. And I would like to give this to you, Ranking Member Kelly, to look at, to see if you would like to join me in that bill. Next is Mr. Gallego. Mr. Gallego. Thank you, Madam Chair. I understand the current interpretation of the law is that military malpractice is an incident to military service. I mean, that shocks me, as a combat infantry Marine. Sergeant Stayskal, Semper Fi, brother. Thank you for being here today. When you were training to become a United States Marine and later Green Beret, were you ever taught that malpractice is incidental to serving in the military? Sergeant Stayskal. No. Nobody ever--you never--it wasn't a discussion, because, you know, when I was young in my career, you had faith in everybody. You know, you didn't know any better at the time. But I had faith. You know, I figured I am serving with the best of the best, everywhere I was at. So to assume that, you know, you would need to worry about something like that just wasn't a thought on your mind, you know? And you assume that your command, your chain of command all the way to the top had your support and they would take care of you. And I would also like to share with you, when I was shot in 2004, I have documentation in my records, a bandage that was stuffed in my back from the battlefield itself wasn't found and pulled out until I was stateside, all the way back in my duty station. Never complained about it, never had an issue with it. That was part of my service, that was a part of combat, and we accepted stuff like that. Things were going to happen; decisions were going to be made. But when I walk in in civilian clothes and I have a scheduled appointment and I am seeking medical care and treatment at that point, you know, I mean, there is no battlefield decisions at that point. It is just a standard of care that should be there. Mr. Gallego. That is right, Sergeant. When I joined, even though I was enlisted, I already had a college degree, but never knew anything about this type of exception that they found under the law. Madam Chair, some of my colleagues have told me that changing this policy would be difficult because of the high cost involved--in other words, that there is so much medical malpractice in the military, it could cost billions of dollars to allow service members the same rights as their fellow citizens. I wonder, Madam Chair, what it says about our military medical system that it is so bad that we have to actually shield it, that it could cost multiple billions of dollars to fully allow tort claims, you know, which I think should scare us all. Madam Chair, the interpretation of Feres by multiple administrations is frustrating. This administration is worse, obviously, that it is willing to steal billions of dollars from recruitment, from counternarcotics accounts, and from crucial military construction accounts to make policy choices about what it likes, but somehow the billions it might cost to provide a more expansive reading of the governing statute and Supreme Court decision is too expensive. The lack of moral prioritization by this administration is galling. Speaking frankly, Madam Chair, the situation we have right here is just unjust. It is wrong. Sergeant Stayskal and Ms. Witt, both of whom have chosen to spend some of this time with us this afternoon, instead of their families, deserve better. I hope that there is something that we can do about the situation, because the moral imperative is clear. This is unjust to our service members and their families. And with immense thanks to all the witnesses, and your time and your sacrifice and your anger, I yield back. Ms. Speier. Thank you, Congressman. Next is Congressman Mitchell. Mr. Mitchell. Thank you, Madam Chair. I would join Mr. Kelly in noting that, while certainly health care of our military is within the purview of this subcommittee in House Armed Services, the judiciary, the process by which who can and cannot sue the Federal Government or other institutions is, in fact, not the purview of this committee. So I am confused. But since we are here, we will proceed with discussing the---- Ms. Speier. Will the gentleman yield? Mr. Mitchell. If you yield me time to make up for it---- Ms. Speier. Absolutely. Mr. Mitchell [continuing]. I certainly will. Ms. Speier. We will stop the clock for a moment. There seems to be a refrain coming from the Republican side of the aisle that is, I think, unwarranted. This is a hearing that we are having about the quality of health care in the military by service members who are not in combat situations. They all have referred to what are medical malpractice cases that indeed come under Feres, but we have every right and responsibility to have a hearing on the quality of health care in the military. And, with that, I will start the clock again. Mr. Mitchell. If you give me a moment to respond to your question---- Ms. Speier. Certainly can. Mr. Mitchell [continuing]. I would appreciate it, Madam Chair. The reality is, the title of the hearing is ``Feres Doctrine--A Policy in Need of Reform.'' So the reality is, if it was about health care, if it was about the provision of health care, which is clearly needing, it is not working well, that would be fine. But it is not. But given we are here today, we will talk about Feres, we will talk about its application, because I think it is important. I will note for my colleague down at the other end that it is not the current administration only that has said that this is a problem and expensive. The United States v. Johnson case was decided May 18, 1987. I think, Mr. Figley, you can help us with how long the Feres doctrine has been in place. Mr. Figley. It has been in place since 1950. Mr. Mitchell. And there has been no effort on the part of the administration to change that that I am aware of. Mr. Figley. It comes up every few years, and I don't believe any administration has supported changing the Feres doctrine. Mr. Mitchell. I will surprise Madam Chair by saying that I am deeply troubled by the Feres doctrine. I have had a chance to read the dissent from the late Justice Scalia to the United States v. Johnson case, and I couldn't agree more with his logic, with his rationale. And I would like to talk to you about your rationale, the one you have hung on to, about--explain to me your rationale as to why Feres should not be addressed. Mr. Figley. My point overall is that Feres serves in a way that treats everybody in the military the same. It is not that military physicians can't be sued. No government position can be sued. Mr. Mitchell. Okay. Let me---- Mr. Figley. They all have immunity. Mr. Mitchell. If we are going to talk about Feres and its uses and application---- Mr. Figley. Yes. Mr. Mitchell [continuing]. And if you are concerned about variations of it based on State claims in various States, then, in fact, we could modify it or amend it to say they all have to be done through Federal court, at which point they would be uniform, would it not? Mr. Figley. No. Mr. Mitchell. Why? Mr. Figley. The basic substance of the FTCA applies the law of the State where the negligent or wrongful act took place. So California malpractice law is different from Oklahoma law. But deeper than that, if you suffer medical malpractice overseas, suit is barred by the foreign tort exception. Mr. Mitchell. You have read the--I assume, I am willing to bet you have read the Scalia---- Mr. Figley. Yes. Mr. Mitchell [continuing]. Dissent in which he was joined by three other Justices, correct? Mr. Figley. Yes. Mr. Mitchell. And, I mean, what response do you have to a pretty compelling argument that Feres simply should not apply? That, in fact, by going for the uniformity you seek, we are mistreating our military members, treating them--a Federal prisoner has more rights to sue the Federal Government than does a member of the military for medical malpractice, among other items. Mr. Figley. Yes, a Federal prisoner can sue the government for medical malpractice. A Federal prisoner cannot sue the Federal Government for an injury suffered in prison industries as a---- Mr. Mitchell. Well, but if you would just answer my question. You have tried to parse it. But if you could just answer it. They can sue for medical malpractice. Mr. Figley. Yes. Mr. Mitchell. Military members cannot. They can't. Mr. Figley. They can--they cannot if it is part of--yes, you are right. Typically, they cannot sue, but---- Mr. Mitchell. So explain to me the rationale, why you would argue at this point in time--and I have looked at your biography and history--that military members should have less rights, which is finally what you said, than a Federal prisoner to pursue claims that they have suffered medical malpractice. Mr. Figley. Because the Federal prisoner does not have the overall compensation---- Mr. Mitchell. Well, you have just explained it from the perspective of a Federal prisoner. What about the perspective of a military member? Mr. Figley. A military member has all of the support systems, put in place by Congress, whether they are adequate or not--and I think---- Mr. Mitchell. With all due respect---- Mr. Figley [continuing]. They are certainly more generous than workers' compensation. Mr. Mitchell. With all due respect, they don't. I mean, we hear from numerous witnesses here--and I apologize. I had a press conference I had to go to, so my apologies. I have read your opening statements. So please understand it is not just out of the blue. And I am offended by it. But, more importantly, Madam Chair, I believe that Feres needs to be addressed not just for medical malpractice. There are other claims that military members should be able to pursue that, in fact, Feres and its subsequent rulings have prohibited. The idea of uniformity. The other is--the other which amazes me is military chain of command. Are you kidding me? We have people being injured because of negligence outside of duties as a combatant. You go to combat, you understand that is the deal. You are in a combat environment, people are taking adverse action, that is the deal. But outside of that, why should they be stripped of their rights while they are sitting on base and someone hits them by a car? Why? Mr. Figley. For the same reason that if you are a bus driver for Greyhound Bus and you are struck by a Greyhound Bus, you can't sue Greyhound Bus as workers' compensation. Now, you could---- Mr. Mitchell. Dr. Stirling, go ahead. Join us, please. I only have a little bit of time, and I apologize, but---- Dr. Stirling. When something happens at a hospital on base, that is between the doctor and the patient. That information doesn't get back to the chain of command. It can't---- Mr. Mitchell. Certainly hopefully not. Dr. Stirling [continuing]. Because of HIPAA [Health Insurance Portability and Accountability Act]. I work as a JAG officer in the Army. It cannot. If it gets back, then the person who has relayed it back will get into trouble. The idea that being able to sue a doctor would affect the good order and discipline of the unit is ridiculous, and it has been rejected by every scholar that I have ever read, to include in the Johnson case. The idea--well, here. I will tell the group this. I have worked for many years as a JAG, as a prosecutor. And what I do is I handle the accusations typically in the sexual assault case, of a survivor of a sex assault who is making an accusation against someone who is in the chain of command. Oftentimes that is against the commander. So here we have a charge made within the unit between a survivor of assault and the commander, and we let those cases go forward. And they don't hurt good order and discipline. So this idea that--if I could just finish. So the idea that if we allow a suit between a patient and a doctor that is completely removed from the chain of command, that it would somehow affect the good order and discipline is just ridiculous. Mr. Mitchell. Well, let me, because I have gone well over my time--and I apologize, Madam Chair. I believe that discussing it solely in terms of medical malpractice is inadequate. I believe that since the courts have failed to deal with this effectively--I don't even agree with the logic of the Feres doctrine to actually believe it---- Dr. Stirling. And I agree with you on that. Mr. Mitchell [continuing]. We need to address this on a more holistic basis so that, in fact, our military should not have fewer rights to protect themselves, to recover in circumstances of negligence, than do other citizens. And right now they do, and it is morally wrong. So, with all due respect, thank you for the additional time. I appreciate it. Thank you very much for being here. I appreciate your service, sir--all of you. I am sorry. Ms. Speier. Thank you, Mr. Mitchell. Mr. Cisneros. Mr. Cisneros. Thank you, Madam Chair. Thank you, Staff Sergeant, Ms. Witt, and Ms. Lipe, for being here today. Ms. Witt, I want to ask you a question just basically based on your testimony. You said you have to apply on an annual basis for you, and I think you said your children biannually, for VA compensation to your husband's death. How much do you get from the VA on a yearly basis, if you don't mind me asking? Ms. Witt. I can give you an approximate number, because I don't have my taxes in front of me. So I believe that there are two different types of benefits. So the Department of Defense has the survivors' benefit, which is taxable. That is paid to my children. And then the Department of Veterans Affairs has the Dependency and Indemnity Compensation that is not taxable, nor is it transferable. If I did not have children, say, if I was a widow to someone who I had not had children with, I would not be able to receive both these benefits together. To answer your question directly, I believe that my children each get about $450 each from the Department of Defense for survivors' benefits, so you can do the math on that if you want. Ms. Speier. And it is taxed. Ms. Witt. And now it is increasingly taxed because of the recent tax codes that have gone up, but---- Mr. Cisneros. Right. Ms. Witt [continuing]. I mean, it can be as much as 37 percent, because it is being treated like a trust for a very wealthy child. Mr. Cisneros. Right. So I will just say, it is not very much. So, Dr. Stirling, if she was permitted to allow a suit for malpractice, I mean, based on your experience, how much do you think she could have gotten? Dr. Stirling. From what I have heard here, Congressman, you know, $10 million or more. That kind of negligence, of the injection of a drug during a routine appendectomy that results in the death of the patient, where there is no explanation for it, it is just an error by the nurse, it would be, you know, $10 million or more. And the idea there is that if we are concerned about a sense of a double compensation, if we are concerned that, oh, she could get a claim for, let's say, $10 million and receive from the VA, we do adjustments like this within the government all the time, where we could reduce the amount of her claim that she got from the FTCA by the amount that she receives from the VA. We can make that adjustment. We do it all the time. There is a lot of concern that I have heard from Mr. Figley about the double-dipping idea, that, oh, there would be a judgment on a lawsuit and--no. We can make that adjustment. We do it all the time. That was one of the points within the dissent within the Johnson case, is we were told by Justice Scalia that these kind of adjustments are done on a routine basis. For instance, I work in the National Guard. I have applied for a claim under the VA for a disability. If I get that claim, if I prevail on that claim and I get some kind of a rating, I won't be able to receive my money from the VA until I am out of the Guard, because, otherwise, it would be seen as a double compensation. We can make those adjustments. Mr. Cisneros. Right. And just one other question. I know, Mr. Figley, you had mentioned that one of the reasons for doing this is because all members of the military are treated equal and to make sure, if one person was able to sue for one injury that they had, when somebody was sitting in the--sharing a hospital room with them, would feel mistreated because of that. And you brought up the fact that after 9/11 those individuals received equal payments. That---- Mr. Figley. No, they did not receive---- Mr. Cisneros. Right. That is not true. Mr. Figley. They received unequal payments. That was the problem. Mr. Cisneros. Correct. So if they received unequal payments in that situation, why couldn't we do that, the same thing for our military folks? It should be, if somebody was treated wrongly and done wrong, why shouldn't they be justified there through the means of being able to sue and get compensation for that mistake and that injustice that was done to them? Mr. Figley. Certainly, Congress can decide to do that. The disadvantage is that people with similar injuries could receive drastically different amounts. If you are injured in Toronto, you would get nothing. If you are injured in Kansas, you would get much less than if you had exactly the same injury in California or New York. Mr. Cisneros. Well, I mean, this is done in Federal--go ahead, Dr. Stirling. Dr. Stirling. Well, it is just, that happens all the time under the FTCA. Under the FTCA, the way that it is written is it is the State law in that State that controls. That happens all the time right now. So why are we using this as an argument to stop a service member from being able to recover when everybody else can? Mr. Cisneros. Right. Yeah. People are able and allowed to sue now for malpractice in different States, and they are not always going to get the same compensation, there is no equality there. Dr. Stirling. Right. Mr. Cisneros. So why should we go on and continue? So my time has expired. Thank you very much. Ms. Speier. Thank you. Ms. Escobar. Ms. Escobar. Thank you, Madam Chair, for bringing us together for this very important hearing. I want to thank all of our witnesses for being here today. I really appreciate your testimony, especially the three of you who have been so deeply, traumatically impacted by what happened to you. Your stories are moving and horrifying and powerful. And, Ms. Witt, your sister is a constituent of mine in El Paso, and she reached out to me. And it is a privilege to get to meet you--all of you, really. My question--and it is somewhat along the lines of what my colleague Mr. Cisneros started talking about with regard to compensation. The purpose of being able to sue when you have been wronged is so that you can receive compensation for your pain, for your suffering, for the time and money that you are out as a result of someone's negligence. And, Ms. Lipe, you mentioned a little bit about the extraordinary amounts of money that you have had to expend personally so you can have a family. And so I am wondering if each one of you wouldn't mind, just very briefly, if you had to put a number on what this has cost you--and I know that it is impossible to put a number on the trauma and the pain and the loss, especially you, Ms. Witt--but the lost income, amount that you have had to spend on physicians. Have you thought about that cost? Have you calculated that before? Ms. Lipe, you are nodding, so maybe we start with you and then we work our way over. Ms. Lipe. I have thought about it, because, to Mr. Figley's point that the VA compensation is adequate, is completely a misstatement. I receive disability compensation. It would have taken me 35 months of my disability compensation to actually pay for what I have paid in for IVF. Additionally, my VA compensation can't--there is no accountability or diagnostic code for infertility. There is no diagnostic code for abdominal pain without any cause. So you can't have everything if you don't have a code to claim. I see it as not only the money I have spent to have my daughter, the money we would need to spend, up to $50,000 probably, to have another child if we would pursue adoption; the pain and suffering I feel every day. I take eight pills a day just to function. As Dr. Stirling said, it would be in the millions, because I don't know for how long I will be able to work. So there is loss of earning capacity. Now, I will say that, yes, I am a lawyer, so I think about it a little more practically, but, for me, it is more the noneconomic, the pain and suffering, the lost time with my family, the days I have to lay on the couch while my husband plays with my daughter and trying to explain to an almost-2- year-old why Mommy can't play with her. I would say it would be in the millions, just for noneconomic. And that is something you can never recover through a VA claim. Ms. Escobar. Right. Thank you. Ms. Witt. I don't know if I have ever actually thought of a dead figure. I know, when I first filed my wrongful death suit, we had to fill in the block for, like, how much money do you want to sue for. And I think we came up with just the loss of income and the fact that my husband was 25 at the time. He was approaching the peak of his earning income, because he wanted to start going to school, start using his benefits for education and become a commissioned officer. So the number that we had figured was about $5 million. And to raise a child, it costs $270,000 from zero to 18. And that barely covers, like, just their basic care. That doesn't cover extras like going on family vacations or extracurricular activities that they want to do. Nor does it cover their education benefits, even though my children will receive education benefits. And then there is just loss of time with my children. I am a single parent. Employers are not very forgiving to single mothers, and it is very difficult to find a job and an employer who is compassionate, that knows, hey, I can't drop off my kids to daycare this day because they have a 104-degree temperature. And even going to school at the time, professors were not very forgiving of me having to miss days or even bring my sick child into the classroom so that I could complete my degree. And then there is just the severity of the loneliness. I have chosen not to remarry because of this, because I will lose this income that is coming in that I will say has major disparities in it that need to be fixed. So I would say, at the time it was $5 million, but I would say, I believe the lawyer at the time that was filing that for me told me that was a very conservative number given what we had gone through as a family and the fact that my husband was essentially brain dead after an appendectomy. Ms. Escobar. Thank you. Sergeant Stayskal. First off, you know, when this illness finally takes me, my wife will join Ms. Witt in all of the same things firsthand. So I don't need to repeat any of that. I am not going to answer, truthfully, ma'am. I am sorry, but I can't put a number on my life. There isn't an amount. You know, I think my kids would probably pay you money to get my life back. But I know, over the last year since we have been off-post to see specialty referrals down in Tampa, Florida, I mean, we drive our own car, we pay for our own gas. I mean, we are 8, 9, 10 hours, 11 hours in the car, every 3 months. Sometimes there was charitable donations that helped us with gas cards; a lot of times there wasn't. You know, I didn't make the law, I didn't pass the law about how best to handle these things was through amounts of money. But my answer would be: whatever amount keeps that practitioner from practicing again. Ms. Escobar. Yeah. Sergeant Stayskal. So that is not up to me to decide. That is up to attorneys and lawyers. That is up to you all in Congress to make those decisions about money. But that would be my answer. Whatever stops that person from making that same mistake again, put that number on it, and that would be my answer. Ms. Escobar. Thank you, Madam Chairwoman. Thank you all. And my point with that was not to try to measure what a life is valued at, but the fact that you were not able to sue and to get compensation. You are losing more than just through pain and suffering, but there is a real cost to the fact that this is happening to all of you. Ms. Speier. Before going to Mr. Crist, I have one question for Ms. Witt. You said that you can't make more than $8,000 a year or you lose your veterans benefit? Could you just clarify? Ms. Witt. Yes, that is right. That is about a round figure from the last time that I checked the website. I receive from the Department of Veterans Affairs the DIC payment, which I think is rated for about half of what my husband's retirement would be if he were to have gone about 20 years in the military and retired in full. As I was looking at that, I don't know how often this is enforced, but I do know that there is an earned-income restriction right around $8,000 or $9,000. And there are also earned-income restrictions with Social Security as well. It is very difficult to find an employer and a job, let alone one that is part-time, that is graded for someone my age. I mean, usually, part-time work usually goes to students and to people who are much younger than me and also don't have children. So unless I had found an employer that can meet those restrictions, I have chosen at this time not to work and just be home with my family. Ms. Speier. So you would probably have taken a full-time position if you didn't have that restriction on a cap of making no more than $8,000 a year. I mean, it is sort of like, you know, adding insult to injury to have that kind of a restriction. I mean, you have been widowed by malpractice in the military system, and you are now struggling to try and maintain a quality of life for your family, all due to the fact that there was malpractice at a military hospital. So we are going to pursue this more. Mr. Crist. Mr. Crist. Thank you. And, Chairwoman Speier, I want to thank you, particularly, for your graciousness in allowing me, as not a committee member, to participate in this hearing today. And so thank you for your leadership, and for all the advocates. And to the three witnesses who have been subject to this horrific Feres doctrine, I can't thank you enough for your courage in being here today, sharing with us your personal story about how this has affected your lives and your families' lives. It takes a lot of strength to do that, and you are commended for it. And it is Sergeant First Class Richard Stayskal? Am I saying that correctly, sir? Sergeant Stayskal. Yes, sir. ``Stayskal.'' Mr. Crist. Great. I am curious, how did you first learn that you would not be able to file a case, you know, in conjunction with what happened to you? Sergeant Stayskal. Well, when I first started talking about it with coworkers and just family and everybody else, you know, the thought was, how is your wife going to provide for herself, how is she going to take care of the kids on a single income, and all that. You know, I am not a big fan of the whole thing, but it made sense. You know, like Ms. Witt was saying, it is a fact; it takes money to raise children and provide for them. So, when I started looking into it first, I believe the first place I went was on Womack down to JAG, and that was my first question. I said, ``Hey, I would like some information about how I would file a lawsuit against a civilian practitioner who works at Womack.'' And the answer I was met with was, ``You cannot.'' And I said, ``Well, why not?'' ``I don't know why exactly, but there is a law that says you cannot.'' That was the best answer he could give me at the time. And then I pretty much just went on from there. So after that, I figured, well, no military JAG was going to help me, so we thought, let's look off-post. So my wife--I think we rounded the number--well, let's call it 10. She called about 10 offices, crying, telling the story over and over and over again. And every time, they said, that is a compelling story, but I am sorry, nobody is going to take your case, and nobody is going to listen to you. That was pretty much how that went until we met a whistleblower law firm down in Tampa, who--they saw the same thing you all are seeing here today, that this is egregious and it needs a fix. Mr. Crist. Well, thank you. I found out about your case, in particular, in Tampa Bay. I represent St. Petersburg and Clearwater on the other side of Tampa Bay from Tampa. And I was with a reporter with our NBC [National Broadcasting Company] affiliate, Steve Andrews. And, you know, we were at Bay Pines, which is our VA hospital in Pinellas County, talking about a different story. And he mentioned to me what was happening to you. And he said, well, what do you think about that? I said, that sounds ridiculous. And he said, well, what do you think ought to be done? I said, we ought to reverse the law. And because of the chairwoman's leadership, we are at that point. But, but for having found out about your circumstance and your situation, similar to the ones that the other two of you have suffered, we wouldn't be here right now, I don't think. And so the leadership by this chairwoman is extraordinary. It is appropriate to be in this committee. You all are related to military or military yourself. This is the Armed Services Committee. I mean, maybe other committees could weigh in too, and maybe they should. But I just can't thank the three of you enough for being here and your courage and your strength, and God bless you. Ms. Speier. Thank you. All right. Do you have any closing remarks you would like to make, Ranking Member? Mr. Kelly. Thank you, Chairwoman. And I don't contest that we shouldn't be hearing this in the committee. My problem is not with Chairwoman Speier in having this hearing, because we have brought this to the attention of the people who can do something. We need to have this hearing in the committee of jurisdiction which can make a change. And my second point to that is, we need to change the things that we can to make it better. Healthcare reform is important, and it is part--this is something we can do, not to help you, but we can keep it from happening to someone else. And, Chairwoman, I appreciate your leadership in having this. And I am going to help you push the Judiciary Committee to do their job and have this hearing over there, where they can fix this part of the problem. So thank you, Chairwoman. Ms. Speier. Okay. Thank you, Ranking Member Kelly. We have been in conversation with a number of members on the Judiciary Committee. They are very anxious to work with us. We wanted to do this jointly with them today, but they had a markup, so that wasn't something that we were able to arrange. But let me just say that this has been a very powerful hearing. Powerful because the three of you came forward to tell what are truly reprehensible experiences. They deserve to be dealt with the way we deal with cases like that that happen to your spouses or your children or that happen through the VA system or that happen to a felon in jail. So this has got to be fixed. The fact that this has been on the books for 69 years because the judges--the Justices, I should say, of the Supreme Court decided to legislate, is wrong. And it is wrong that it has gone on as long as it has without the Congress of the United States putting their big- people britches on and doing the hard work to come up with a solution that is going to provide justice and that is going to treat service members like others are treated in Federal service in a noncombatant setting. So we have lots to do, but you have given us the grist that we will use in order to make sure that we move forward on this. So we are deeply grateful to all of you, and also to you, Dr. Stirling and Mr. Figley, for bringing your perspectives to this hearing. We now stand adjourned. [Whereupon, at 3:53 p.m., the subcommittee was adjourned.] ======================================================================= A P P E N D I X April 30, 2019 ======================================================================= ======================================================================= PREPARED STATEMENTS SUBMITTED FOR THE RECORD April 30, 2019 ======================================================================= [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT] ======================================================================= DOCUMENTS SUBMITTED FOR THE RECORD April 30, 2019 ======================================================================= [GRAPHIC(S) NOT AVAILABLE IN TIFF FORMAT]