Above: Fourth Infantry Division soldiers carry the casket of Staff Sgt. Glen H. Stivison Jr., who was a mentor to Kash Alvaro. Mark Reis / The Gazette

Coming Home

The Assassins came home to Fort Carson in February 2010 to a flurry of ceremony. Commanders gave speeches, the Colorado Rockies held a tribute for the 11 soldiers killed in the battalion, the whole unit got a steak dinner from a volunteer group called the All-American Beef Battalion.

Alvaro couldn't handle any of it. He kept seeing the pieces of his friends and smelling the burning trucks. He could not concentrate. He heard voices that were not there. Still too young to go to bars, he drowned his symptoms in tequila in his apartment off-post. Soon after coming home, Alvaro was awarded the Army Commendation Medal for dedication to duty and selfless service but felt as if he had failed. He had not protected his friends. Why had those men, those fathers, died, and not him?

In March 2010, a month after coming home, he went to the hospital at Fort Carson with two broken hands. He told doctors he had hurt them playing football, records show. In reality, he said, he had been thinking about the men who died and punched a wall until he bled.

That spring, Army doctors diagnosed Alvaro with PTSD and TBI, medical records show. He began seeing a civilian psychiatrist weekly and getting medication for depression, nightmares and persistent headaches.

Robert Alvarez Veterans advocate says other-than-honorable discharge sets soldiers up for failure. Michael Ciaglo / The Gazette

Then the seizures started. One night two months after getting back, Alvaro went to a barbecue at a friend's house. Suddenly, he got a strange metallic taste in the back of his mouth and fell writhing to the floor. An ambulance took him to Fort Carson's hospital. It was a trip he made several more times in the next year, medical records show. Seizures came on unexpectedly accompanied by splitting headaches and chest pains that felt like a heart attack, Alvaro said.

"We'd be chilling in his room or something and his eyes would roll back in his head," said Chance Fraher, a soldier who said he took Alvaro to Fort Carson's hospital on several occasions. Fraher was also later kicked out for misconduct and soon became homeless.

Alvaro started getting in trouble. He didn't seem to listen any more. He had a surly attitude. He was lethargic, soldiers said. He got written up for arguing with a sergeant and showing up late for duty.

"It's not unusual after a hard deployment, 90 or 100 days out to start seeing the problems, the drinking, the fighting," Menchaca said. "A good leader has to look for that and be ready for it."

But 100 days out, Menchaca had left for another assignment. So had the company's captain, Papkov. New commanders took their place.

Alvaro was missing duty to go see doctors. He was showing up late complaining of seizures. Yet he had no Purple Heart proving he'd been injured.

Despite growing medical evidence and repeated efforts to educate the ranks, an attitude lingers in the Army that dishonest soldiers use PTSD or TBI as an excuse to get out of duties — and a way to cheat the Army out of benefits — and doctors are too quick to diagnose them, soldiers said. Despite all that happened in Afghanistan, Alvaro was seen as one of them.

"He was not a good soldier," said Sgt. Kimberly Grant, the senior medic in the company.

Alvaro had been caught in Afghanistan with a government BlackBerry that did not belong to him, she said, and mouthed off to superiors, so he got a reputation as a troublemaker.

"As far as his seizures, no one really believed him," she said.

On top of that, many of his superiors had a poor understanding of his injuries. Asked about Alvaro's blast injury and hospital stay in Afghanistan, Grant said it never happened.

"They thought I was a malingerer," Alvaro said. "They'd say things like 'worthless soldier, you're just garbage; I don't know why you are in the Army.' "

Kash Alvaro sits alone in the dining room of a friend's apartment this winter. He became homeless shortly after he was discharged. Michael Ciaglo / The Gazette

"He was a dirt bag," his former squad leader, Sgt. David Daniels, said when reached on Facebook.

A new first sergeant, Paul Jones, took over the Assassins. Jones, assigned to rebuild the company for another deployment, said he would not be giving medical discharges for any "sorry excuses," soldiers said.

"He didn't like you, whatever you may have done wrong, even if you haven't done nothing wrong, he was going to bring something up on you, and he did," Alvaro said.

Jones and 22 other soldiers, sergeants and officers in the company contacted for this story did not respond to requests for comment, but doctors' notes in Alvaro's medical records tell a story of a unit bent on making his life difficult.

The Assassins interfered in medical appointments, refusing to give Alvaro rides to appointments, then writing him up for the appointments he missed.

When an ambulance showed up in September 2010 after Alvaro collapsed during training, an incident report shows, a sergeant told the paramedics Alvaro "has done this before" and "This 'episode' is just another attempt to gain sympathy."

Invisible wounds

With Alvaro, the Assassins were struggling with a larger problem the military has yet to solve: If a wound is invisible, how can anyone tell it is real? And even if it is real, how can anyone tell if it's responsible for a soldier's conduct?

In the past five years, the military has spent more than $700 million on TBI studies, in part to try to answer these questions. It has spent millions more so the Army can identify and treat soldiers. Since 2007, Fort Carson has increased its behavioral health and brain injury staff by four times.

Col. Dallas Hack, who heads the Army's medical research branch, said technological advances will one day be able to definitively show not only whether brains are damaged but how the injuries affect decision-making.

"We are in the midst of a neuro trauma renaissance. We are making very fast progress," he said. "But some of these advances are still years in the future."

For now, Hack said, the military is in the difficult position of knowing TBI and PTSD are serious injuries but not being able to say definitively who has them or what functions they affect.

Maj. Gen. Joseph Anderson Unedited audio interview with Fort Carson's former commander conducted by Dave Philipps Michael Ciaglo, Dave Philipps / The Gazette

The uncertainty can cause confusion for leaders who must enforce discipline, especially young leaders at a platoon level who encounter the injuries most often.

"It's hard to figure out," said Maj. Gen. Anderson, who was the final authority for discharging soldiers at Fort Carson. "You are asking young captains, 30-year-old guys, platoon leaders, 25 years old, to decide if this guy is sick or this guy is not sick when the doctors don't know for sure."

The uncertainty sets up clashes. The Gazette has uncovered several cases at Fort Carson where doctors and commanders were in direct conflict. Doctors sent one soldier who pointed a gun at the soldiers in his squad to a psychiatric hospital, and commanders pulled him out and put him in jail. Doctors said another soldier who tested positive for marijuana could not be kicked out because he had a brain injury. Commanders discharged him anyway. Another soldier tried to commit suicide by crashing his car into a light pole. Doctors said he had PTSD and depression; commanders discharged him for damaging property.

Several doctors contacted at Fort Carson refused to comment.

Anderson refused to discuss individual soldiers but stressed he can't ignore regulations because someone is hurt.

"You do your job, we're going to do right by you," he said. "But guys that are being disrespectful, steal from their buddies, all those things that bring down discipline on the post, we are not going to tolerate."

The Army is allowed to kick out wounded soldiers who break the rules as long as someone in the behavioral health staff determines the conduct was not caused by service-related injuries. This creates an incentive for soldiers to be misdiagnosed, critics say.

With no clear guidelines, Anderson said, he judges soldiers by their service.

"My job is to look at the pattern," he said. "We all make mistakes, and soldiers in that population are a high-risk population. We don't crucify them all for one offense. Two offenses? It depends. There is no set rule. I look at every case independently and say what is medical and what is the pattern of conduct up to that point."

A review of recent Fort Carson cases shows, though, that soldiers are discharged for one offense.

In October, a sergeant named Dennis Tackett, who had been a handler of bomb-sniffing dogs in three tours in the wars in Iraq and Afghanistan, came before Anderson. Diagnosed with PTSD, with a history of suicide attempts and in the medical discharge process, the soldier with a clean record had punched a man in the face while drunk.

Anderson had the authority to let the sergeant medically retire but threw him out for misconduct.

"He said my PTSD didn't make me drink," Tackett said. "I made that decision."

The waiting wounded

Average number of days to medically discharge a soldier Army-wide Data from Government Accountability Office

A collision of forces created the surge in misconduct discharges, observers say.

First, the Army no longer needs as many soldiers. During the height of the wars in Iraq and Afghanistan, Fort Carson would overlook drunken driving or minor civilian charges and even illegally deploy soldiers with active felony cases. Now, the Army is looking to cut 80,000 soldiers by 2017 and may eliminate an additional 100,000 troops during the next 10 years due to the sequester. In response, it has tightened discipline standards.

"You have a bunch of worn-out, used-up troops. The easiest thing to do is get rid of them. They did the same thing in Vietnam," said William Brown, a professor of sociology at Western Oregon University who was a lieutenant at Fort Carson during the Vietnam War and now studies veterans.

Second, the system for medically discharging injured soldiers, known as the Integrated Disability Evaluation System, or IDES, is overwhelmed. Army-wide it has 28,000 soldiers. More wounded troops are waiting longer to get out of the military. It now takes on average 418 days at Fort Carson, not including the months before the soldier enters the formal process. In the meantime, troops suffering from injuries that can encourage misconduct are more likely to "engage in negative behavior" that could get them thrown out, a 2012 Government Accountability Office report about the stalled medical process said.

Army Reserve Sgt. Maj. Michael Chumbler Wounded soldiers count against end strength. Michael Ciaglo / The Gazette

Third, the waiting wounded are a burden to their units, observers say, because the wounded can't deploy but can't be replaced until the clogged medical system discharges them. The Army has special battalions designed to take wounded soldiers off the rolls of combat units, but it is difficult to get in with just PTSD or TBI, according to civilian advocates and Army medical staff at posts across the country.

These wounded soldiers can cripple a combat unit, affecting its ability to fight and inhibiting the career advancement of its commanders, Army officers said. Because of this, commanders have incentive to find ways to get rid of the wounded. The fastest way is a misconduct discharge.

Finally, other avenues for quickly getting rid of underperforming troops have been blocked by Congress. During much of the Iraq War, the military could discharge soldiers by saying they had a pre-existing mental condition, often what it called a "personality disorder." An estimated 31,000 veterans have been discharged this way since 2001. After Congressional hearings in 2007, the military put safeguards in place that made that type of discharge increasingly slow and difficult, causing some commanders to look for other quick ways to discharge problem soldiers.

"The system is broken," said Michael Chumbler, a command sergeant major in the Army Reserves who works as a civilian with troubled veterans in Colorado Springs. "In the last 10 years, warfare has evolved. Armor has evolved. Medical care has evolved. We have a lot of guys coming home who never would have. And the system that deals with them afterward has failed to evolve, too. Something has to change."

'A pig in a python'

The Assassins wanted to get rid of Alvaro through something called Chapter 14.

The ways a soldier can get an "administrative separation" from the Army are spelled out in separate chapters of Army regulations, so soldiers often call it getting "chaptered out." Soldiers can get chaptered out for all sorts of things including Chapter 8, pregnancy; Chapter 9, alcohol or other drug rehabilitation failure; and Chapter 14, separation for misconduct.

In September 2010, the Assassins tried to chapter Alvaro out for mouthing off and stealing the BlackBerry, but the unit was stopped because Army rules require any soldier who is in trouble but has TBI or PTSD to have a full medical evaluation. An Army psychologist halted Alvaro's Chapter 14, saying the soldier "has significant symptoms of PTSD and TBI and cannot be cleared." He recommended Alvaro for a medical discharge instead, medical records show.

Regulations don't prohibit the Army from kicking out a wounded soldier but do require the soldier to complete the medical evaluation process first so the Army can know the extent of injuries.

That put the Assassins in a tight spot. They were headed to Afghanistan again in 17 months. Medically discharging Alvaro would take about 14 months. Until he was gone, the unit could not get a replacement.

A medical discharge requires a gamut of physicals by the Army and VA to identify injuries and assign a disability rating that determines cash benefits.

"It can take a long time," said Lt. Col. Vincent Barnhart, who runs the medical discharge system at Fort Carson, adding that the surge of injured now working their way through the program is like "a pig in a python" and Fort Carson still has a significant bulge.

The situation is the same at Army posts across the country. The glut has increased the wait for medical discharge 47 percent Army-wide since 2008, the Government Accountability Office said.

The military and VA are adding staff to deal with the backlog but have yet to cut the wait, the Department of Defense said.

The delay encourages units to kick soldiers out, observers say.

"It makes commanders do what they wouldn't ordinarily do," said an officer at Fort Carson who wished to remain anonymous for fear of retribution. "They have a motive to circumvent the system. And it's the soldier who pays the price."