SEATTLE — A few weeks after Jarrid Starks ended his Army service in May, he went to an office in Albany, Ore., to enroll for veterans health care benefits.
Starks brought medical records that detailed post-traumatic stress disorder, a twisted vertebra and a possible brain injury from concussions. Other records documented his tours of duty in Iraq and Afghanistan, where his bravery fighting the Taliban was recognized with a Bronze Star for valor.
None of that was enough to qualify him for health care from the Department of Veterans Affairs.
That's because Starks left the military this year with an other-than-honorable discharge — his final year of service scarred by pot smoking and taking absences without leave.
He was told to fill out a form, then wait — possibly a year or more — while officials review his military record to determine whether he is eligible for health care.
"I was absolutely livid," Starks, 26, recalled. "This just isn't right."
Starks is among the more than 20,000 men and women who exited the Army and Marines during the past four years with other-than-honorable discharges that hamstring their access to VA health care and may strip them of disability benefits.
Some were booted out of the military before they deployed.
Others served in combat zones in Iraq and Afghanistan, then struggled upon their return with drug abuse, unauthorized leaves and other misconduct that placed them among the most troubled members of the generation of veterans who fought in the long wars launched after Sept. 11.
Starks ended his military career this spring with a weeklong stay at Madigan Army Medical Center under psychiatric care. Then, he was escorted to the front gate of Joint Base Lewis-McChord carrying a brown paper bag packed with a 90-day supply for six prescription drugs that included antipsychotics, antidepressants, pain pills and beta-blockers.
As he left the Army to re-enter the civilian world, Starks opted to wear a cap with a peculiar patch: "Warning, This Vet Is Medicated For Your Protection."
Amid a surge in suicides among recent veterans, politicians have increased VA budgets by billions of dollars to help expand and improve the treatment of PTSD, traumatic brain injuries and other conditions. They talk about forging a "seamless transition" from military medical care to the VA.
But federal law draws a sharp dividing line between honorably discharged veterans, who are offered access to veterans health care and disability compensation, and those whose misdeeds may put those benefits at risk.
Veterans who fall below the threshold of an honorable discharge must submit to a VA review of whether they engaged in "willful and persistent misconduct," and if so, whether that makes them ineligible for health care or disability benefits.
"Each case is going to be different, so it is important to go through all the evidence," said Leah Mazar, a Veterans Benefits Administration analyst. "This is not something the VA makes up. This is based on the laws and regulations."
In response to a Seattle Times request for the number of veterans ruled ineligible for benefits, VA officials said the department has no way to track how many of these reviews are conducted, how long they take or their outcomes.
In recent years, the federal law that guides veterans benefits has come under fire from a surprising source: some Army lawyers frustrated by the frequency with which troubled combat veterans are tossed out of the military without ready access to VA health care.
"I would go so far to say that, when we speak of Army values, leaving no soldier behind, there is almost a moral obligation," said Maj. Evan Seamone, chief of Military Justice at Fort Benning, Ga., who in 2011 published a Military Law Review article critiquing the Army legal system.
"We are creating a class of people who need help the most, and may not be able to get it. And, when you do that, there are whole families torn apart, and higher levels of crime. It's a public health and public safety issue."
In another Military Law Review article, Maj. Tiffany Chapman, a former Army prosecutor, argues that Congress should overhaul a 1944 federal law that authorizes the VA to determine whether veterans without honorable discharges are eligible for benefits.
"Out of fairness to the soldier who risked his life in combat, Congress must amend current legislation to ensure that all veterans who suffer from service-connected PTSD are able to obtain treatment regardless of the circumstances under which they were separated from the military."
Others say that granting such benefits would disrespect the vast majority of service members who go to war and complete their service honorably.
"The veterans who advise our program, they are still firm that an honorable discharge should be the standard for care," said George Dignan, a King County, Wash., official who helps to administer veterans programs.
A King County veterans program and a state program that offer PTSD counseling have patterned eligibility after the federal law and do not extend services to veterans who have an other-than-honorable discharge.
In Congress, there has not been much discussion about changing the law.
Sen. Patty Murray, D-Wash., said that she is concerned about any veterans who find themselves "outside of the VA looking in" and that the appeals process needs to be "vastly improved."
But Murray, chairwoman of the Senate Veterans' Affairs Committee, does not favor new legislation and said these veterans should continue to have their access to health care determined on a case-by-case basis.