Department of the Navy

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Secretary of the Navy Council of Review Boards
Department of the Navy Disability Evaluation
System Naval Health Clinic Quantico, VA
7 Dec 2006
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Bottom LineUp-Front

• Performance based system.
• A medical diagnosis MAY NOT be a disability.
• Referral to PEB does NOT always spell the end of
  a career.
• Service HQ has final disposition authority.
• COs assessment is critical!

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DoD DisabilityEvaluation System

• Established by law (Title 10 USC, Chapter 61).
• Enacted to preclude service members separation
  due to medical condition without an opportunity
  to demonstrate fitness to continue service.
• Compensation for loss of career cut short by
  service illness or injury incurred while in
  receipt of basic pay.

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DoN Disability Evaluation System Objectives

• Maintenance of a physically fit and combat ready
  force
• Equitable consideration of the interests of
  government and individual service member

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PEB Mission

• Determine a service members fitness for
  continued naval service.
• (FIT or UNFIT)
• Rate members whose disabling injury or illness
  is determined to have been incurred or aggravated
  while in receipt of basic pay.
• Ensure members right to a full and fair hearing.

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Our Business

• Taking care of Sailors and Marines
• Facilitate the Navy and Marine Corps in the
  management of personnel resources

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DoN Disability Evaluation System

• The DES is a performance-based system!
• Designed to provide member every
• opportunity to be found FIT and avoid a
• medical discharge.
• Can the member do their job?
• Disabling condition may warrant
• disability retirement or severance.

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Disability Evaluation System Process

• Deliberate and documented process
• Multi-phased
• Record review (Informal PEB (IPEB))
• Reconsideration of IPEB finding
• Personal appearance hearing with legal counsel
  (Formal PEB (FPEB))
• Petition for relief
• BCNR

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Case Processing Flow
How does the PEB work?
PETITION FOR RELIEF
INFORMAL BOARD
FORMAL BOARD
MEMBER
HOSPITAL
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Desired Case Processing Time
30 days light duty (90 max) 6-12 months limited
duty 1 month board dictation (72 days
average)
MEMBER
MTF

MEDICAL EVALUATION BOARD REPORT
INFORMAL BOARD
40 days from receipt of the MEB (16 days average)
FORMAL BOARD
90 days from receipt of the Findings
45 days from receipt of PFR
PETITION FOR RELIEF
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CASE PROCESSING

Finding
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CASE PROCESSING

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LIMDU or Fit for Full Duty?
Where does the Marine Corps
need this Marine?
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Enough to crew an aircraft carrier and embarked
wing
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LIMITED DUTYDETERMINATIONS

• True LIMDU population unknown
• Placement on LIMDU driven more by events than
  medical conditions
• Deployment cycle
• PCS orders to operational/overseas unit
• PRT or PFA cycle

NO PEB CASELOAD PREDICABILITY
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How PEB Referral Has Been Decided

• When maximum benefit of medical treatment and
  rehab attained
• When all available SIQ, Light Duty, Convalescent
  Leave, and LIMDU exhausted (12 months)
• When Service HQ denied additional LIMDU
• When Death Imminent

NOT OPTIMAL FOR READINESS
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PromptIdentification

• It is not within the mission of the Department
  of the Navy to retain members on active duty or
  in the Ready Reserve to provide prolonged,
  definitive medical care when it is unlikely the
  member will return to full military duty.

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PromptIdentification

• Accordingly, line commanders, commanding
  officers of MTFs, and individual medical and
  dental officers shall promptly identify for
  evaluation by medical boards and appropriate
  referral to the PEB, those members presenting
  for medical care whose physical or mental fitness
  to continue is questionable.

Section 1005 SECNAVINST 1850.4E
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WhyPrompt Referral?

• Preserves the interests of the government and
  individual service member.
• Government
• Helps maintain operational readiness
• Individual
• Return to duty or provided DoD disability
  compensation (Severance or Retirement)
• Access to VA benefits compensation

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Prompt PEB Referral

• Enables member to make informed decisions once
  made aware of benefits (DoD, DVA, DOL and Social
  Security) available.
• If eligible and elects, can continue treatment at
  MTF as retiree while receiving other benefits
• DVA benefits and compensation often greater and
  encompass family

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PEB Referral Decisions

• Attending physician
• MTF Medical Evaluation Board
• MTF Convening Authority
• CNO or CMC may direct

NOT

• Individual service member
• Commanding officer

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CASE PROCESSING

Finding
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Informal / Formal Board

• Composition
• - One Physician (O-5/O-6)
• - One Navy line officer (O-5/O-6)
• - One Marine line officer (O-5/O-6)
• Functions
• - Evaluate fitness for continued naval
  service
• - Validate line of duty determination
• - Assign VA code(s) /Determine disability
• - Make combat related determination
• - Issue preliminary findings letter
• - Recommend findings with rationale

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Who - What - How?

PEB Board 1 - Physician (O6 or O5) 2 Line
Officers (O6 / O5 / O4)
MEB Report
COs Assessment
Members Rebuttal
Physical Exam
Entire Medical Record
LODI
All Inpatient Records (Labs)
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The mere presence of a medical condition does NOT
necessarily result in UNFIT finding or
entitlement to a disability rating.
Diagnosis Vs Disability
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What is FIT?

• FIT Member can reasonably perform duties of
  their office, grade, rank or rating.
• PEB balances impact of members diagnoses, via
  objective medical and performance evidence,
  against members ability to perform duties of
  office, grade, rank or rating.

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What is Not FIT?

• FIT does not mean fit for full duty or
  suitable. (Suitable means member meets all
  requirements for an overseas, remote or
  operational assignment)
• Although the PEB determines that a member is FIT,
  he/she may not be able to
• Pass PFA/PFT
• Deploy
• Serve in Special Duty assignments
• (flight, parachute, dive, submarine,
  etc.)

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UNFIT Call Characteristics

• Condition significantly impairs members ability
  to perform appropriate duties
• Multiple clinic or Emergency Room visits
• Objective findings on physical exam
• Commanding Officers assessment indicates job
  limitations, and / or absences from work

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Use of VASRD

• Directed by DODI 1332.39
• Chapter 61, Title 10, USC established VASRD as
  the standard for assigning disability ratings
• Portions not applicable to military departments
• Rating applied to only military (occupational)
  unfitting conditions

http//ecfr.gpoaccess.gov
Electronic Version Access
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Disability Rating Disposition

• Member lt 20 years and a Disability Rating
  lt 30 Separate
• Member lt 20 years and a
  Disability rating gt 30 TDRL or PDRL
• Member gt 20 or more years and a Disability
  Rating TDRL or PDRL

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Compensation

• Severance pay computed using
• 2 X Base Pay X Years
• (maximum 12 years)

• TDRL placement results in a
• minimum 50 of Base Pay to a
• maximum of 75

• PDRL compensation based on
• of disability rating

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Secretary of the Navy Council of Review Boards
Combat Related

• Engaged in Extra Hazardous
• Service
• Direct Result of Armed Conflict
• Conditions Simulating War
• Instrumentality of War

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CASE PROCESSING
Case Processing

Finding
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Who - What - How?

PEB Board (Formal) 1 - Physician (O6 or O5) 2
Line Officers (O6 / O5 / O4)
COs Assessment
MEB
Addendum
Revised
LODI
Inpatient Records (Labs)
New
Legal Counsel
Member Testimony
Service appointed or Personal retain
Personal appearance
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CASE PROCESSING

Finding
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Normal Case Flow (UNFIT FINDING)
MTF forwards Medical Evaluation Board Report
to PEB
PEB notifies SVC HQ. Mbr command notified of
HQ disposition action. (Day 90)
PEBLO informs mbr. Mbr accepts. (Day 80)
PEB accepts case (Day 1) Informal PEB (IPEB)
findings issued. (Day 5)
Formal PEB considers case. (Day 70)
PEBLO informs mbr of UNFIT findings. Election
of options mbr req reconsider. (Day 16)
IPEB reconsiders. No change. PEBLO informs mbr.
Mbr demands formal hearing. (Day 30)
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Case Volume

• 5500 Active duty and Reserve
• 2100 Temporary Disability Retired List
  (reevals)
• OEF / OIF
• 1200

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Secretary of the Navy Council of Review Boards
OEF/OIF CASE PROCESSING

• Marine Corps (1105 Total)
• Adjudicated
• 896 USMC
• 161 USMCR
• - Total Combat
• Related cases 796
• In-process
• 35 USMC
• 13 USMCR

• Navy (195 Total)
• Adjudicated
• 112 USN
• 75 USNR
• - Total Combat
• Related cases 96
• In-process
• 4 USN
• 4 USNR

25 SEP 06
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DOD vs DVA System

• DOD
• Determine a service members medical
  fitness for military duty
• Compensate for a loss of future military
  earnings
• DVA
• Determine service connection of disability
• Compensate for the loss of future civilian
• earning capacity

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DOD vs DVA System
DOD
DVA

• Auth 10 USC chap 61
• Only unfitting conditions rated
• Ratings are permanent upon PDRL or separation
• Not bound by DVA rating decisions

• Auth 38 CFR
• Service connected injuries/illness rated
• Ratings may change over time
• Not bound by military decisions

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Prompt PEB Referral

• PEB UNFIT finding does NOT always result in
  separation
• Service HQ retains disposition authority
• Can grant PERMANENT LIMITED DUTY
• Have better visibility into force readiness

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Permanent Limited Duty (PLD)

• A Service Headquarters decision
• Member found UNFIT by the PEB
• Member accepts PEB decision
• Member requests PLD approval via chain of command
• HQ may continue member on active duty

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Questions ?