Under Defense Department guidance, the military services are supposed to provide baseline cognitive assessments to all service members who work in jobs that involve blast exposure and track them throughout their careers.
But the services have been unable to complete those requirements because they are hampered by a lack of resources, including a shortage of staff and the technology needed to conduct such assessments, according to a new report from the Government Accountability Office.
In 2024, after extensive reporting by The New York Times on the impact routine weapons training can have on the brain, including traumatic brain injury, the Pentagon issued several policies to protect troops from blast overpressure.
The policies included restrictions on the proximity trainers should have to weapons at firing ranges. They also called for increasing the use of simulators in training, conducting cognitive assessments of all troops and monitoring exposure.
The policies also required new recruits to receive cognitive assessments by the end of 2024. Screening for all active-duty personnel in “high-risk” specialties — such as those who handle howitzers, mortars, M 107 and MK 15 sniper rifles, breaching charges and other weapons — was supposed to be completed by the end of fiscal 2025.
The GAO found that nearly 200,000 recruits were screened in fiscal 2025 and 86% of personnel in occupations at increased risk received assessments, with 87% of Army personnel, 81% of Air Force members and 59% of Navy sailors screened.
But service officials told GAO analysts that they faced challenges fully meeting their obligations and evaluating personnel because of the tight timeline set in memos. They said they did not receive the resources or staff to conduct the assessments and relied on existing resources to meet requirements.
In terms of monitoring service members at regular intervals following their initial assessments, the Defense Health Agency said it did not have enough specialists to meet requirements.
Officials in the Office of the Under Secretary of Defense for Personnel and Readiness told the GAO that insufficient industrial hygienists were the “primary barrier to DOD achieving its targets for exposure tracking.”
The Pentagon announced in April that it will begin a one-year pilot program to test a new cognitive assessment tool, an app that service members can use to complete assessments. DoD officials said the app will be less “resource intensive” than current assessments and will help improve the services’ ability to track exposures.
GAO officials also said the Pentagon has taken several steps to educate service members and ensure they receive care if they show symptoms.
According to the GAO, the DoD now distributes informational material to service members on blast exposure, instructs leaders to schedule training breaks and encourages troops to seek treatment. The department is working to improve access to specialty care while also educating military doctors on blast exposure.
“DOD has taken critical steps to prevent and mitigate service members’ exposures to blast overpressure, steps intended to help protect their brain health and the readiness of our country’s military forces,” the report stated.
GAO made two recommendations, saying the department should complete an assessment of the resources needed to implement the policies and take steps to ensure the services have adequate industrial hygiene staff support.
In response, Under Secretary of Defense for Personnel and Readiness Keith Bass said the department is on its way to completing the resource assessment and has taken steps to meet the industrial hygiene staff requirements.
“DOD estimates it will complete the actions for both recommendations by December 2026,” Bass wrote.
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.
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