Overview of the Physical Disability Evaluation System (DES)

The Secretary of the Army is charged with ensuring the fitness of Soldiers, and separating or retiring those who become unfit to continue military service because of physical disability. The law provides benefits for eligible Soldiers whose military service is cut short due to a service-related disability incurred in the line of duty.

The United States Army Physical Disability Agency (USAPDA) manages the Army's DES and acts on behalf of the Secretary of the Army. USAPDA is a Field Operating Agency of the Army Human Resources Command (HRC) and is headquartered in Washington DC at Walter Reed Army Medical Center. In addition to the USAPDA HQ at Walter Reed, the agency has three Physical Evaluation Boards (PEBs), located at Walter Reed, Ft. Sam Houston, TX and Ft. Lewis, WA. The PEBs are administrative boards that determine whether a Soldier’s medical condition prevents his/her continued service in the Army. The PEB is comprised of two types of boards (Informal and Formal) that review medical and service evidence to make determinations of fitness or unfitness to continue military service. 

It is important to understand that this is a performance-based system. Simply because a Soldier has a medical condition does not mean that the Soldier cannot continue to serve on active duty or in the Reserve Component. It is the impact of that medical condition upon the Soldier’s ability to perform duties appropriate to his/her rank and branch/MOS that is important. A Soldier with a serious medical condition can be found fit within the limits of his/her profile for continued service if the evidence supports that finding.

MEDICAL EVALUATION BOARD (MEB):         The MEB will determine if you have conditions that are disqualifying for retention. They do not make fitness determination, nor do they assign ratings. Their most important function as far as your case is concerned is in accurately diagnosing your conditions, and providing other info in their Narrative Summary (NARSUM). In order to find what conditions are disqualifying you should look here, depending on your Branch of Service:

If you have conditions that they are not considering, you have the right to appeal the findings and recommendations of the MEB.  You may also augment the draft NARSUM provided to you by your MEB before the final MEB finding NARSUM is codified and sent to the PEB for percentage disability rating.

You can only be rated by the PEB for conditions that are unfitting. The following contain the regulations for each Service's PEB:

Coast Guard COMDTINST M1850.2D

Here are the regulations covering the MEB for each Service:

Coast Guard COMDTINST M1850.2D

The PEB is comprised of two types of boards, Informal and Formal. A board (Informal or Formal) is composed of a three-member panel trained on adjudication standards and procedures. The Presiding Officer will normally be a Colonel (sometimes a Lieutenant Colonel). In addition, each board has a Personnel Management Officer (normally a field grade officer or civilian equivalent) and a Medical Member (normally a DA civilian physician). In addition, there will be a representative of the Department of Veterans Affairs (VA) on the PEB. Almost all of the civilian board members at the Army PEBs are retired military with significant experience. By law, all PEBs considering a Reserve Component (RC) Soldier will have an RC member.

If the PEB determines that a Soldier is unfit to continue military service, and finds that the Soldier is eligible for disability benefits, the PEB determines percentage of the Soldier's disability compensation using Department of Defense Directives (DoDD) and Instructions (DoDI), Army Regulations, and current Army policy in conjunction with the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD).

The Army only rates those medical conditions that result in the Soldier being determined unfit for continued military service. The Department of Veterans Affairs (DVA) generally rates a Soldier for all conditions incurred in or aggravated by military service. It used to be, before the FY 2008 NDAA, that it was not uncommon for a former Soldier to receive a higher combined disability rating from the VA than the PEB combined disability rating. However, NOW the Department of Defense PEB must use the Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) for its PEB disability ratings –inn other words, the two disability percentage ratings will normally be the same.  The MEB & PEB disability rating percentage can never be less than the VA disability rating.

A Soldier is unfit to continue in the Army when the preponderance of evidence demonstrates that one or more physical and/or mental condition(s) significantly interferes with the Soldier's ability to perform the duties of his/her office, grade or rank. The PEB makes the decision on fitness by balancing the extent of a Soldier’s condition, as shown through objective medical and performance evidence, against the requirements and duties that the Soldier may reasonably be expected to perform in his/her branch/MOS and grade. The mere fact that one or more medical conditions exist does NOT constitute an unfit determination.

• A narrative summary written by the Medical Evaluation Board (MEB)

• History and treatment of the specific injury or illness

• Results of laboratory, X-ray, MRI, CAT scan and other specialized tests

• Current Physical Profile

• All referrals to physicians, specialists and sick call (health record)

• Type and frequency of medication

• Results of physical exam completed within past six months

• Memorandum from the Soldier’s Commander addressing current ability to perform duties in MOS and unit

• Evaluation Reports

• Army Physical Fitness Test (APFT)

• Approved Line of Duty investigations

Subtitle A—Policy on Improvements to Care, Management, and Transition of Recovering Service Members

SEC. 1612. MEDICAL EVALUATIONS AND PHYSICAL DISABILITY EVALUATIONS OF RECOVERING SERVICE MEMBERS.

(1)  IN GENERAL.—Not later than July 1, 2008, the Secretary of Defense shall develop a policy on improvements to the processes, procedures, and standards for the conduct by the military departments of medical evaluations of recovering service members.

(2) ELEMENTS.—The policy on improvements to processes, procedures, and standards required under this subsection shall include and address the following:

(A) Processes for medical evaluations of recovering service members that—

(i) apply uniformly throughout the military departments;

and

(ii) apply uniformly with respect to recovering service members who are members of the regular components of the Armed Forces and recovering service members who are members of the National Guard and Reserve.

(B) Standard criteria and definitions for determining the achievement for recovering service members of the maximum medical benefit from treatment and rehabilitation.

(C) Standard timelines for each of the following:

(i) Determinations of fitness for duty of recovering service members.

(ii) Specialty care consultations for recovering service members.

(iii) Preparation of medical documents for recovering service members.

(iv) Appeals by recovering service members of medical evaluation determinations, including determinations of fitness for duty

(D) Procedures for ensuring that—

(i) upon request of a recovering service member being considered by a medical evaluation board, a physician or other appropriate health care professional

who is independent of the medical evaluation board is assigned to the service member;

and

(ii) the physician or other health care professional assigned to a recovering service member under clause (i)—

(I) serves as an independent source for review of the findings and recommendations of the medical evaluation board;

(II) provides the service member with advice and counsel regarding the findings and recommendations of the medical evaluation board;

and

(III) advises the service member on whether the findings of the medical evaluation board adequately reflect the complete spectrum of injuries and illness of the service member.

(E) Standards for qualifications and training of medical evaluation board personnel, including physicians, case Deadline workers, and physical disability evaluation board liaison officers, in conducting medical evaluations of recovering service members.

(F) Standards for the maximum number of medical evaluation cases of recovering service members that are pending before a medical evaluation board at any one time,

and requirements for the establishment of additional medical evaluation boards in the event such number is exceeded.

(G) Standards for information for recovering service members, and their families, on the medical evaluation board process and the rights and responsibilities of recovering

service members under that process, including a standard handbook on such information (which handbook shall also be available electronically).

(1) IN GENERAL.—Not later than July 1, 2008, the Secretary of Defense and the Secretary of Veterans Affairs shall develop a policy on improvements to the processes, procedures, and standards for the conduct of physical disability evaluations of recovering service members by the military departments and by the Department of Veterans Affairs.

(2) ELEMENTS.—The policy on improvements to processes, procedures, and standards required under this subsection shall include and address the following:

(A) A clearly-defined process of the Department of Defense and the Department of Veterans Affairs for disability determinations of recovering service members.

(B) To the extent feasible, procedures to eliminate unacceptable discrepancies and improve consistency among disability ratings assigned by the military departments and the Department of Veterans Affairs, particularly in the disability evaluation of recovering service members, which procedures shall be subject to the following requirements and limitations:

(i) Such procedures shall apply uniformly with respect to recovering service members who are members of the regular components of the Armed Forces and recovering service members who are members of the National Guard and Reserve.

(ii) Under such procedures, each Secretary of a military department shall, to the extent feasible, utilize  the standard schedule for rating disabilities in use by the Department of Veterans Affairs, including any applicable interpretation of such schedule by the United States Court of Appeals for Veterans Claims, in making any determination of disability of a recovering  service member, except as otherwise authorized by section 1216a of title 10, United States Code (as added by section 1642 of this Act).

(C) Uniform timelines among the military departments for appeals of determinations of disability of recovering service members, including timelines for presentation,

consideration, and disposition of appeals.

(D) Uniform standards among the military departments for qualifications and training of physical disability evaluation board personnel, including physical evaluation board liaison personnel, in conducting physical disability evaluations of recovering service members.

(E) Uniform standards among the military departments for the maximum number of physical disability evaluation cases of recovering service members that are

pending before a physical disability evaluation board at any one time, and requirements for the establishment of additional physical disability evaluation boards in the event

such number is exceeded.

(F) Uniform standards and procedures among the military departments for the provision of legal counsel to recovering service members while undergoing evaluation by a

physical disability evaluation board.

(G) Uniform standards among the military departments on the roles and responsibilities of non-medical care managers under section 1611(e)(4) and judge advocates assigned to recovering service members undergoing evaluation by a physical disability board, and uniform standards on the maximum number of cases involving such service members that are to be assigned to judge advocates at any one time.

(1) IN GENERAL.—The Secretary of Defense and the Secretary of Veterans Affairs shall jointly submit to the appropriate committees of Congress a report on the feasability and advisability of consolidating the disability evaluation systems of the military departments and the disability evaluation system of the Department of Veterans Affairs into a single disability evaluation system. The report shall be submitted together with

the report required by section 1611(a).

(2) ELEMENTS.—The report required by paragraph (1) shall include the following:

(A)  An assessment of the feasibility and advisability of consolidating the disability evaluation systems described in paragraph (1) as specified in that paragraph.

(B) If the consolidation of the systems is considered feasible and advisable—

(i) recommendations for various options for consolidating the systems as specified in paragraph (1); and

(ii) recommendations for mechanisms to evaluate and assess any progress made in consolidating the systems as specified in that paragraph.

2.    ADVOCATE:            The next crucial phase is the Formal PEB. Here, a good advocate can present your case in the strongest manner, but equally important is identifying and preserving the legal errors made in your case. Veterans’ Service Organizations (VSO) have experts on hand to assist you and help represent your case—USE THEM!  The three at WRAMC Health Care System are: Disabled American Veterans (DAV); American Legion (AM); and Paralyzed Veterans of America (PVA).

3.    APPEAL:       The third crucial phase is in appealing the decision if the PEB has made an error in your case. So start educating yourself and preparing for your case early. In this way, you can better understand what is happening with your case and you can ensure you have the evidence you need to get an accurate rating. Waiting until you are at the Formal hearing before preparing is putting yourself at a disadvantage.

You will receive “Medical Retirement” pay based on your (1) combined disability rating percentage, or you will receive retirement pay based on (2) your years of service.

Title 10 U.S. Code; Chapter 61; now allows those service members with less than 20 years credible service for retirement to be retired disability (“Medical Retirement”) if their DES (MEB & PEB) disability rating is 30% or greater.  That is to say, they are retired just like any other service member who served 20 or more years.  They have all the same benefits of a retired military service member.  These service members are sometimes called “Chapter 61 Retirees.”

If all your unfitting conditions result in a combined disability rating of 30 percent or higher, and your condition is considered stable (meaning it is unlikely, in the doctor’s opinion that your disability rating will change within five years), you will be permanently retired for disability and placed on the PDRL.

This provides you with disability retirement pay, access to TRICARE for you and your dependent family members enrolled in the Defense Enrollment Eligibility Reporting System (DEERS), access to commissary and exchange shopping, and all other benefits of regular military retirement. The local finance office or the DFAS Wounded Warrior Pay Management Team will help you calculate the amount of retirement pay you will receive.

REFERENCE: United States Code, Title 10, Chapter 71, Section 1401

Your PDRL (Medical Retired) retired pay will be determined by DFAS using Formula Number 1 of United States Code, Title 10, Chapter 71, and Section 1401.

Service members receives disability retirement pay based on the combined disability rating percentage, or will receive retirement pay based on their years of service—whichever is greater in dollar $ amount. The service member receives the amount that is greater of the two methods for determining the pay, but it cannot exceed 75 percent of base pay.

COMBINED DISABILITY RATING PERCENTAGE: 100%  Under this method, DFAS “Medical (disability) Retirement is based on the combined disability percentage retirement pay but can never be more than 75 percent of base pay, so a combined rating of 80 -100 percent will result in retirement compensation equal to 75 percent base pay.  Other percentages based on DES (MEB & PEB) percent disability are:

1)    PDRL Retirement: Combined disability rating percentage from the MEB & PEB:

Combat Related Special Compensation (CRSC): Historically, veterans have not been allowed to receive both military retirement pay and disability compensation from VA.

offset of VA compensation for combat-related disabilities that reduced DoD retirement payments. However, you must apply for CRSC after you are Medically Retired and have a DD 215 or DD215.  Normally the AW2 representative will be able to direct you to the CRSC office so you can prepare this application before your Medical Retirement such that you can, like  for your VA Disability, submit immediately upon your retirement date.

â     MILITARY RETIREES WITH LESS THAN 20 YEARS SERVICE:

The law was expanded by the 2008 National Defense Authorization Act (effective 01 October 2007) to include members who are retired with less than 20 years for medical reasons (Military Medical (Disability) Retirement). Eligible veterans with VA-rated disabilities that have been determined to be combat related and who have A) 20 or more years of creditable service, OR who are permanent (PDRL) medical retirees, OR B) who have been placed on the TDRL, are eligible for a monthly Combat Related Special Compensation (CRSC) payment in addition to their reduced military retirement pay and their VA disability compensation.