Integrated Disability Evaluation System - USI

ARMY MEDICINEOne Team…One PurposeConserving the Fighting Strength Since 1775

Integrated Disability

Evaluation System

Information Brief

UNCLASSIFIED/FOUO

David A. Twillie, MD

Chief, Soldier Readiness

Blanchfield Army Community Hospital

Fort Campbell, KY

UNCLASSIFIED// FOUO

Slide 2 of 18Dr. David Twillie/ 270-461-1563 / [email protected]


Purpose and Outline

Outline:

1. The Focus

2. Army Integrated Disability System

3. The Direction of Military Medicine

4. Discussion

Purpose: Understanding how service members exit the military

UNCLASSIFIED// FOUO



Two distinct systems

DoD (Law and Policy)

• The DES shall be the mechanism for

determining return to duty, separation, or

retirement of Service members because of

disability in accordance with chapter 61 of

10 USC.

• The DES shall consist of five elements:

medical evaluation; disability evaluation,

including appellate review; counseling;

specific case-management; and final

disposition. The medical and disability

evaluations shall be executed by

Medical Evaluation Boards (MEBs) and

Physical Evaluation Boards (PEBs) for

each respective Military Department.

VA (Law and Policy)

• In accordance with 38 USC, Department

of Veterans Affairs conducts an

evaluation for physical disability and

assigns a rating of disability when

appropriate in accordance with the

schedule for rating disabilities utilized by

the Secretary of Veterans Affairs

(VASRD).

UNCLASSIFIED// FOUO



DES Update

Legacy DES

DD

214

DES Referral

MEB PEB Transition

VA Claim

VHA VBA

DoD Benefits(Title 10)

VA Benefits(Title 38)

BENEFIT

GAP

Medical

Treatment

Phase

Months

UNCLASSIFIED// FOUO



DES Update

Integrated DES

DD

214

DES Referral

MEB PEB Transition

VA Claim

VHA VBA

Medical

Treatment

Phase

Both DoD and VA Benefits(Title 10 & 38)

NO

BENEFIT

GAP!!!

Months

7

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UNCLASSIFIED// FOUO



DES Update

• A single set of medical examinations

• Single-sourced disability ratings

• Faster disability processing

• Increased transparency

• Enhanced case management

• Closes the benefits gap

UNCLASSIFIED// FOUO


ARMY MEDICINEOne Team…One PurposeConserving the Fighting Strength Since 1775 IDES Process

MTF/MEB PEB/PDA VA/DRAS

MTF- Military Treatment Facility

MEB- Medical Evaluation Board

PEB- Physical Evaluation Board

PDA- Physical Disability Agency

VA- Veterans Administration

DRAs- Disability Rating Active Site

UNCLASSIFIED// FOUO



IDES Timeline/Goal Comparisons

Soldiers are referred

within 1 year of being

diagnosed with a

medical condition that

does not appear to meet

medical retention

standards or when it is

known that no amount

of treatment will enable

the Soldier to meet

retention standards.

UNCLASSIFIED// FOUO



• Maintain an effective and fit military organization with maximum use of

manpower

• Provide benefits for eligible Soldiers whose military Service is terminated

because of disability incurred in the line of duty (LOD)

• Provide prompt disability processing while ensuring that the rights and

interests of the Government and the Soldier are protected

UNCLASSIFIED//FOUO

Objectives of DES

UNCLASSIFIED// FOUO



• Initiated when one or more medical conditions (referred conditions) are

identified by a military healthcare provider as having reached the level requiring

referral into DES

• Is a set of processes designed to evaluate a Soldier’s medical condition(s) to

determine whether they meet retention standards, or if one or more of the

conditions (alone or in combination) do not meet retention standards;

– Document a Soldier’s medical condition(s) and duty limitations

– Deliver a finding regarding fitness for continued military service

– If found fit – the Soldier is returned to duty (2% of Soldiers are RTD)

– If determined to be unfit, determine if the Soldier should be medically

separated (with or without benefits), temporarily or permanently retired, or

(subject to approval of a Soldier’s request) continued on duty

• During the process – DES staff members provide Soldiers counseling and

advice on how to contribute to the development of their case as well as rights

and responsibilities applicable when presented with the results of various stages

of the process

UNCLASSIFIED//FOUO

Purpose of DES

UNCLASSIFIED// FOUO



• Shall develop an implementation plan to include:

– Efforts to eliminate duplicative activities carried out by the DHA and

the Military Departments.

– Efforts to maximize efficiencies carried out by the DHA.

– How the Secretary will implement in a manner that reduces the

number of members of the Armed Forces, civilian employees who

are full-time equivalent employees, and contractors relating to the

headquarters activities of the military health system

• Report to Congress (RTC): Final due NLT 01 March 2018

– Interim RTC submitted 31 March 2017

– 2nd Interim RTC submitted 30 June 2017

– 3rd Interim RTC submitted 30 March 2018

– Final RTC due no later than 30 June 2018 (Extended 3 months)

THE SECRETARY OF DEFENSE

FY17 NDAA Section 702

Secretary of Defense

Component Model

UNCLASSIFIED// FOUO



Alignment of

Major Functions

• DHA Major Functions

– Healthcare Administration and Management

– Administration Policies and Procedures

– Budgetary Matters

– Military Medical Construction

– Information Technology

– MTF and Purchased Health Care Operations

– MTF Based Readiness

• Military Department Major Functions

– Identification of Operational Requirements

– Recruit, Organize, Train, Equip Medical Personnel

– Health care Services provided on Installations separate from

MTF Health care delivery/operations

– Provide Ready Medical Forces

– Enable Medical Ready Forces

20

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Pre-Discharge Redesign

20

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Pre-Discharge Redesign

20

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‒

•

•

•

UNCLASSIFIED// FOUO



Purpose

1. The Focus

2. Army Integrated Disability System

3. The direction of Military Medicine

4. Discussion

Purpose: Understanding how service members exit the military

Integrated Disability Evaluation System - USI

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