June 26, 2024

GAO Accepts Warren, Lawmakers’ Request to Review DoD Efforts on TBI and Blast Overpressure

Text of Letter from GAO (PDF) 

Washington, D.C. – In response to a request from lawmakers led by Senators Elizabeth Warren (D-Mass.), Chair of the Senate Armed Services Personnel Subcommittee; Joni Ernst (R-Iowa), Ranking Member of the Senate Armed Services Emerging Threats and Capabilities Subcommittee; and Representatives Ro Khanna (D-Calif.) and Elise Stefanik (R-N.Y.), both members of the House Armed Services Committee, the U.S. Government Accountability Office (GAO) announced that it will review the Department of Defense’s (DoD) efforts to identify, prevent, and treat traumatic brain injuries (TBI) related to servicemembers’ exposure to blast overpressure. 

“DoD has spent billions on researching Traumatic Brain Injuries, but there are still major gaps in getting service members the help that they deserve. We must act to protect our service members, and the GAO will help us review those efforts and identify key areas to mitigate the impacts of blast overpressure on service members,” said Senator Warren.  

In the original request, the lawmakers asked the GAO to review DoD research on TBI, blast overpressure, and blast exposure as well its efforts to identify those most at-risk for blast overpressure and to protect service members from retaliation for seeking care for TBI.

The original request was also signed by Senators Rick Scott (R-Fla.), Mazie Hirono (D-Hawaii.), Kirsten Gillibrand (D-N.Y.), Angus King (I-Maine), Susan Collins (R-Maine), Ben Cardin (D-Maine.), Tim Kaine (D-Va.), Martin Heinrich (D-N.M.), Markwayne Mullin (R-Okla.), Thom Tillis (R-N.C.), Dan Sullivan (R-Alaska) and Representatives Robert Garcia (D-Calif.), Sanford Bishop (D-Ga.), Joseph Morelle (D-N.Y,), Jared Golden (D-Maine.), Jimmy Panetta (D-Calif.), Chellie Pingree (D-Maine.), Chrissy Houlahan (D-Penn.), Seth Moulton (D-Mass.) and Susie Lee (D-Nev.).

In April 2024, Senators Warren and Ernst and Representatives Khanna and Stefanik introduced the bipartisan Blast Overpressure Safety Act to better mitigate the risks of and protect service members from blast overpressure. The bill is endorsed by the Wounded Warrior Project, the Military Officers Association of America (MOAA), Veterans of Foreign Wars (VFW), Disabled American Veterans (DAV), the Navy SEAL Foundation, and the Cohort of Chronically Concussed Mortarmen (C3M). 

The Senate’s and House’s fiscal year 2025 National Defense Authorization Act both include a number of provisions from the Blast Overpressure Safety Act, including requiring DoD to update blast overpressure safety thresholds and establish blast overpressure and TBI logs; to consider blast exposure during the weapons acquisition process; and to develop strategies for protecting those service members who are most at risk. 

Senator Warren has led efforts to measure blast exposure and develop protocols that protect service members:

  • In May 2024, Senators Warren (D-Mass.), Ernst (R-Iowa), and Representatives Ro Khanna (D-Calif.) and Elise Stefanik (R-N.Y.) asked the U.S. Government Accountability Office (GAO) to review the Department of Defense’s (DoD) efforts to identify, prevent, and treat traumatic brain injuries (TBI) related to service members’ exposure to blast overpressure.
  • On April 11, 2024, Senators Warren and Joni Ernst introduced the Blast Overpressure Safety Act – bipartisan legislation that would direct the Department of Defense (DoD) to enact a variety of measures to help mitigate and protect service members from blast overpressure. Representative Ro Khanna (D-Calif.) and Representative Elise Stefanik (R-N.Y.) introduced the bill in the House of Representatives.
  • In February 2024, Senator Warren led a hearing on the impacts of blast overpressure on American ]service members and the need for DoD to better protect service members from blast overpressure. 
  • In January 2024, Senators Warren, Ernst, and Tillis sent a letter to Secretary of Defense Lloyd Austin, asking him to provide updates on steps the DoD is taking to better understand and address the effects of blast exposure on service member mental and physical health during training and operations. 
  • In May 2019, Senators Warren and Ernst introduced the Blast Pressure Exposure Study Improvement Act, which would require more frequent progress reports from DoD regarding the longitudinal study and added two feasibility assessments to the study.
  • Senator Warren introduced an amendment in the Fiscal Year 2018 National Defense Authorization Act (Sec. 734) that required DoD to establish a longitudinal medical study examining the effects of blast pressure exposure. 
  • In May 2018, Senators Warren and Ernst introduced the Blast Exposure and Brain Injury Prevention Act to improve research on TBIs, speed up the development of therapies to treat TBI, and strengthen DoD’s capacity to track and prevent blast pressure exposure.

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