Defense Bill Orders Military to Take New Action on Brain Injury

On Wednesday, Congress passed comprehensive new mandates to enhance brain safety for military personnel, requiring the Pentagon to implement stricter limits on blast exposure, monitor and report such exposures throughout a soldier’s career, and modify existing weapons to reduce risks. For the first time, the military will also factor brain safety into the design of new weapons.https://wordpress.com/

These provisions are part of the $895 billion National Defense Authorization Act, which was approved by the Senate on Wednesday after passing the House last week.

The measures mark a significant shift in how both Congress and the military approach the risks of blast exposure, also known as overpressure. Growing evidence this year has highlighted the dangers to service members, who may sustain brain injuries from repeated weapon use or from high-performance equipment like fighter jets and speedboats. Until now, the military has largely overlooked the issue.

Senator Elizabeth Warren, who introduced the measures, noted, “It’s been a hard fight to get to this point. Finally, there was widespread acknowledgment of a problem with blast overpressure and its impact on the brains of our service members.”

The annual military spending bill, which covers everything from pay to equipment procurement, often serves as a platform for lawmakers to push for their priorities, including social issues.

The new provisions require the military to address a longstanding issue it has largely ignored—blast exposure. Historically, the military considered weapons blasts that didn’t cause immediate concussions as safe, with little consideration given to the cumulative effects of repeated exposure to blasts from heavy weapons like howitzers and rocket launchers.

Lawmakers pointed to emerging research, ongoing reporting by The New York Times, and a mass shooting in Maine committed by an Army Reserve soldier with brain damage from blast exposure as key triggers for the Pentagon and Congress to reevaluate the risks.

“This is something that’s been overlooked for years, and I don’t think anyone made the connection,” said Senator Angus King of Maine. “Now, it’s front and center.”

One key turning point was the case of Sergeant First Class Robert Card II, who killed 18 people and then himself in October 2023. Card had been exposed to thousands of blasts as a weapons instructor, and had exhibited signs of mental health issues before the incident. Posthumous tests of his brain revealed extensive damage consistent with blast-related injury.

“We needed more than just thoughts and prayers,” King said. “We must understand what happened and take action to prevent it from happening again.”

In response, King and Senator Jerry Moran of Kansas introduced a bill requiring the Department of Veterans Affairs to study and report on the link between repeated blast exposure and mental health issues, and improve both diagnosis and care.

The symptoms of brain injuries caused by blast exposure—such as insomnia, anxiety, and depression—have often been misdiagnosed as post-traumatic stress disorder or noncombat-related mental health issues, while the underlying physical brain damage was overlooked.

The new bill mandates that the military standardize procedures for detecting, treating, and reporting these injuries. Military doctors typically require a specific injury event, such as a roadside bomb explosion, to diagnose traumatic brain injury (TBI). However, for troops exposed to constant blasts, there often isn’t a single identifiable event, so these injuries went unreported.

The legislation also requires improvements in the identification and management of these injuries. The military has already started addressing the issue, with the Department of Defense releasing new guidelines in August to reduce and track exposure, including baseline brain function assessments for all new recruits. Since then, 36,000 troops have been evaluated.

The Army has also implemented new training protocols, limiting the number of rounds troops can fire daily and spreading out training over several weeks to allow time for recovery between exposures.

The Marine Corps has introduced virtual training simulators to reduce blast exposure during certain exercises.

At the same time, the military is working to modify existing weapons. In October, the Army showcased a new breaching explosive designed to direct more of the blast away from soldiers using it.

Frank Larkin, a former Navy SEAL who has been advocating for years to raise awareness of blast exposure, expressed cautious optimism. “For a long time, there was little progress, but we’re finally making headway. However, we still have a long way to go,” he said.

Larkin’s advocacy stems from the tragic loss of his son, Ryan Larkin, who served in the Navy SEALs and experienced undiagnosed brain injuries from repeated exposure to blasts. Ryan died by suicide in 2017, and an autopsy revealed extensive brain damage.

“Ryan kept telling us something was wrong, but no one would listen,” Frank Larkin said. “I hope no one else has to go through what we did.”

While the new Pentagon requirements are a step forward, challenges remain in fully understanding and addressing the problem. Researchers still don’t know the exact threshold at which blast exposure begins to damage brain tissue, or whether factors like the shape of the blast wave, multiple exposures in a short time frame, or genetics play a role in the likelihood of injury.

Currently, no reliable method exists to detect cumulative blast injuries in living service members; these injuries can only be confirmed after death. As a result, while Congress is instructing the Pentagon to track these injuries, the military lacks a foolproof way to identify affected troops.

Treatment options are also limited, mainly focusing on symptom management, with no approved therapies yet to repair brain tissue directly.

“This brain health issue is truly a national security concern,” Frank Larkin emphasized. “Our ability to think on our feet is what gives us an edge. We need to take this seriously, as it’s already affecting recruitment and retention. People need to know that we’ll take care of our military personnel and their families.”