Her husband, Bill, is a major in the California Army National Guard. In February 2003, Bill was among the first soldiers mustered for Iraq. But Bill never got that far. During readiness training at Fort Lewis in Tacoma, he injured his back lifting equipment.

He never deployed with the 1498th Transportation Company. Three years later, Bill lives in a hotel room near Madigan Army Hospital in the grip of a medical hold from which the couple seems helpless to escape.

First, the Army sent the Gulf War veteran and father of four home to California for local care through the military’s community-based clinic system. But after Bill started having problems with blurry vision and headaches, the health system’s local commander told him he was faking his symptoms and could be charged with malingering.

The Army ordered the 43-year-old back to Madigan Hospital. Since then, his wife says, he’s had three different diagnoses for symptoms that a private doctor says could be multiple sclerosis. But, in order for Bill to get a medical discharge with the benefits he’ll need, such as VA hospital care, the Army has to give him a disability rating of 30 percent or above—something Katie and Bill have been fighting for through a seemingly endless cycle of evaluations, ratings and appeals.

"My husband has been on medical hold for three years and one month," Katie says. "There’s only two other soldiers [at Fort Lewis] close to three years."

In the weeks since the Washington Post broke the scandal on conditions at Walter Reed Hospital in Washington, D.C., the 30 percent rating has emerged as the injured soldier’s line of defense at Madigan and other Army facilities that have come under scrutiny. Many, like Katie’s husband, are fighting for the government to take care of them as veterans, not drop them on the curb.

If Bill doesn’t get a high enough rating, Katie says, the Army will write him a lump-sum severance check for his disability and he’s done. Forever. After 21 years of service – 14 on active duty – she says there would be no doctors, no PX, and nothing from the Veterans Administration.

About 160 reservists find themselves on a medical hold at Madigan today, with the hospital noting another 60 holds on active duty personnel. But it’s what happens after a disabled soldier is discharged—particularly one with a mental or physical dysfunction that impairs their ability to fight the system—that worries many Seattle-area veterans and the advocates who serve them.

Between Sept. 11, 2002, and the end of November, the VA’s Puget Sound Health Care System reports, a total of 3,005 veterans from Iraq or Afghanistan have entered the system, with the King County Veterans Program noting a 30 percent jump in requests for help in just the past year.

Counselors and service providers say it’s only the beginning of a tidal wave that’s already flooding the system, increasing wait times for help and creating a backlog of 10,000 veterans simply waiting to enroll in the Northwest region VA system, according to Skip Dreps, government affairs director for Seattle’s Paralyzed Veterans of America.

And, unlike the draftees Dreps served with during the Vietnam era, today’s lean, mean fighters are enlisted National Guard or reserve members like Bill Morisette, a pharmaceutical salesman for Johnson & Johnson. Once the reservists get out, counselors say, they’re more isolated from the system and often don’t recognize a problem they may be having with pain, cognitive function, or post-traumatic stress.

Katie says Bill, who served in the first Gulf War, sometimes wakes her up in the middle of the night saying he can smell burning flesh. But she’s sure that won’t count in her husband’s upcoming disability review. The primary psychiatrist at Madigan, she says, gives no one a diagnosis of post-traumatic stress disorder. Instead, they’re diagnosed as having an anxiety disorder.

Katie believes that’s no accident. While PTSD can rate a 30 percent disability, the Army can give anxiety disorder a zero, Katie says.

Col. George Giacoppe, deputy commander of clinical services at Madigan Hospital, says the anxiety diagnosis is not deliberate. It merely reflects that soldiers don’t provide the proper paperwork. To get a diagnosis of PTSD, a soldier must have exhibited signs and symptoms for a period of time, he says, and present a letter from a commander or fellow soldier documenting that he or she witnessed a traumatic event.

The colonel also points out that, unlike the medical hold for an active-duty member, a reservist seeking discharge is being screened in part for disabilities that might not qualify for benefits.

“The piece that really gets the reserve and Guard service members upset is a condition prior to service,” Giacoppe says. If a prior disease or injury makes a soldier unfit for service, “you may not receive compensation for that,” he says.

At the Puget Sound VA, which has a current enrollment of 58,000 vets, spokesperson David Tostenrude says there’s currently no wait to enroll in the primary care program and that he’s unaware of an enrollment backlog in the Seattle area.

That may be true of the Puget Sound VA, but “we’re behind the curve,” Dreps says of the soldiers coming home. “We never thought that we would be receiving this amount of casualties. It’s overrun the system.”