More than 1.6 million American service members have deployed to Iraq and Afghanistan in Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). As of December 2008, more than 4,000 troops have been killed and over 30,000 have returned from a combat zone with visible wounds and a range of permanent disabilities. In addition, an estimated 25-40 percent have less visible wounds--psychological and neurological injuries associated with post traumatic stress disorder (PTSD) or traumatic brain injury (TBI), which have been dubbed "signature injuries" of the Iraq War. National Council on Disability (NCD) concurs with the recommendations of previous Commissions, Task Forces and national organizations that: (1) A comprehensive continuum of care for mental disorders, including PTSD, and for TBI should be readily accessible by all service members and veterans. This requires adequate staffing and adequate funding of Veterans Administration (VA) and Department of Defense (DoD) health systems; (2) Mechanisms for screening service members for PTSD and TBI should be continuously improved to include baseline testing for all Service Members pre-deployment and follow up testing for individuals that are placed in situations where head trauma may occur; and (3) The current array of mental health and substance abuse services covered by TRICARE should be expanded and brought in line with other similar health plans. As this report indicates, the medical and scientific knowledge needed to comprehensively address PTSD and TBI is incomplete. However, many evidence-based practices do exist. Unfortunately, service members and veterans face a number of barriers in accessing these practices including stigma; inadequate information; insufficient services to support families; limited access to available services, and a shortage of services in some areas. Many studies and commissions have presented detailed recommendations to address these needs. There is an urgent need to implement these recommendations. (Contains 4 exhibits.)