Advanced OT Training Enhances Care

Photo By Roan Smith | Members of Occupational Therapy teams from throughout the Defense Health Network-National Capital Region recently attended the U.S. Army’s 7H Skill Identifier Upper Extremity (UE) Neuromusculoskeletal (NMSC) Course held at Walter Reed to enhance care for beneficiaries with UE injuries.  

UNITED STATES

08.18.2025

Story by Bernard Little  

Walter Reed National Military Medical Center

By Bernard S. Little
Walter Reed Office of Command Communications
When a torn tendon or wrist fracture sidelines a service member, the injury isn’t just painful – it can halt careers, delay deployments, and drain operational strength. At Walter Reed National Military Medical Center, occupational therapists (OTs) are stepping up with the skills to change that.
Walter Reed recently hosted the U.S. Army’s 7H Skill Identifier Upper Extremity Neuromusculoskeletal (NMSC) Course, training military and civilian OTs from across the National Capital Region (NCR) to enhance care for beneficiaries with upper extremity (UE) injuries.
“OTs work as force multipliers, increasing the early access to direct care for UE injuries,” said U.S. Army Col. Enrique Smith-Forbes, chief of OT Services in Walter Reed’s Department of Rehabilitation.
The course is traditionally held at Brooke Army Medical Center in San Antonio, Texas. Hosting it at Walter Reed gave more OTs in the NCR access to the specialized training without the cost of traveling to San Antonio. This also contributes to less time lost for the force in the NCR.
The 7H Skill Identifier (SI) is a special designation granted to U.S. Army OTs who complete at least a year-long process including a preceptorship, advanced coursework, and clinical residency. Therapists who earn it can evaluate and treat patients without needing to have a physician referral. Therapists can also order imaging and lab tests, prescribe selected nonsteroidal anti-inflammatory drugs (NSAIDs), write short-term limited duty profiles, and initiate evidence-based treatment – all independently.
This skill identifier “designates 65A/Occupational Therapy positions with special Category II clinical privilege skills to perform direct access clinical care for the management of upper extremity conditions,” Smith-Forbes explained.
That care is critical. Musculoskeletal injuries account for approximately 25 million limited duty days annually, according to Veronique Hauschild of the Defense Health Agency-Clinical Public Health and Epidemiology Directorate in Aberdeen, Maryland. “When on limited duty status, a service member may not be able to maintain required training activities and may not be deployable,” she said.
The 7H Skill Identifier Course content reflected the complexity of these UE injuries accounting for those limited duty days: tendon and nerve damage, fracture management, shoulder impairments, radiology, surgical decision-making, rheumatology, pharmacology, nutrition, and electromyography (EMT)/nerve testing considerations and care.
In addition to Walter Reed OT staff members, participants came from Fort Meade, Maryland and the Uniformed Services University to attend the course. Feedback was overwhelmingly positive, Smith-Forbes said.
“They said because of the training they felt better equipped to manage patients,” he said.
Advanced clinical training doesn’t just enhance care, it keeps the force mission ready.
“I am very pleased with the quality of Walter Reed’s 7H course and the willingness of all the cadre to include physicians, surgeons, and other clinical staff to teach this course,” Smith-Forbes said.
For more information about OT at Walter Reed, visit https://walterreed.tricare.mil/Health-Services/Specialty-Care/Occupational-Therapy, or call 301-400-1382.

• Date Taken: 08.18.2025
• Date Posted: 08.18.2025 13:12
• Story ID: 545862
• Location: US