Appendix G
DISABILITY EVALUATION SYSTEM TRAINING TOPICS FOR
PRIMARY PARTICIPANT POPULATIONS ACROSS
MILITARY DEPARTMENTS
As noted in Chapter 5, the suggested purpose of the DES and set of desired outcomes
shaped the suggested performance competencies for primary participant populations, which in turn shaped the selection of DES topics for training content. Chapter
5 groups the DES topics into six distinct training packages with each containing a
specific body of DES knowledge for the relevant primary participant population clusters. In contrast, Table G.1 presents the raw data that served as the basis for the
training packages presented in Chapter 5.
Table G.1 contains a comprehensive list of DES topics and our assessment of which
primary participant populations require knowledge of a given topic. The topics are
listed in the order in which we collected the respective data. This data array informed
the organization and development of the content of the six training packages.
We gleaned much of what appears in Table G.1 directly from OSD disability policy
documents, augmented by existing military department syllabi and policy documents, and through observation of military department training programs and
interviews with primary participants. A few of the topics listed in the table—such as
“Difference Between VA and DoD DES”—came directly from our analysis and other
recommended interventions noted in this report.
Note: The full range of information included within some knowledge areas is shown
in the table in italics. Not all primary participant populations require knowledge in
every DES topic area.
191
Utopia
DES Topics
References (statutes,
directives, instructions)
Statutory basis of the DES
DoD DES purpose
DES desired outcomes
DES (process and steps)
Eligibility for referral for full
disability adjudication,
including checklist to
determine eligibility
Waiver of DES processing
Service member rights,
benefits, and entitlements
Incompetency cases
Service member restrictions
imposed by the DES
Effect of PEB findings and
decision
Impairment versus
disability
Unfit versus unsuitable
(conditions that do not
constitute a physical
disability)
X
X
X
X
X
X
X
X
X
X
Utopia Semibold
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Patient
Administrators
X
PEB
Administrative
Action
Officers
X
Primary Participants
Medical
Evaluation
PEB
Medical
Board
Members/
EvaluaApproving Approving
tion Board
AuthorAuthorMembers
ities
ities
X
X
X
X
X
X
X
X
X
X
PEBLOs/
Disability
Evaluation
Counselors
X
Physicians
Who
Write
Narrative
Summaries
X
X
X
X
X
X
X
X
X
X
X
X
Post-PEB
Appellate
Review
Board
Members
X
X
X
X
X
X
X
X
X
X
X
X
X
Attorneys
Who
Represent
Service
Members
X
Initial Formulation of Disability Evaluation System Topics for Primary Participant Populations
Table G.1
X
X
X
X
X
X
Active
Component
Unit
Commanders
X
X
X
X
X
X
X
X
X
X
X
X
Reserve
Component
Commanders
X
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Improving Performance of the DoD Disability Evaluation System
Utopia
DES Topics
Medical board coordination
among service member,
MTF, PEB, and military
department personnel
organizations
Role of primary participants
in the DES
Difference between VA and
DoD DES
Temporary early retirement
authority
Waiver of disability
retirement pay for
Reserve retirement
Transfer to the retired
Reserve and early
qualification for retired
pay
Service member election of
options
Standards for determination
of fitness
X
X
X
X
X
X
X
X
X
X
X
X
X
Utopia Semibold
X
X
X
X
X
X
X
X
Patient
Administrators
PEB
Administrative
Action
Officers
X
Primary Participants
Medical
Evaluation
PEB
Medical
Board
Members/
EvaluaApproving Approving
tion Board
AuthorAuthorMembers
ities
ities
X
X
X
PEBLOs/
Disability
Evaluation
Counselors
X
Physicians
Who
Write
Narrative
Summaries
Table G.1—Continued
X
X
X
X
X
X
Post-PEB
Appellate
Review
Board
Members
X
X
X
X
X
X
X
Attorneys
Who
Represent
Service
Members
X
X
Active
Component
Unit
Commanders
X
X
X
X
X
X
Reserve
Component
Commanders
DES Training Topics for Primary Participant Populations Across Military Departments
193
Utopia
Permanent limited duty
(continuation on active
duty or active Reserve
status)
Compensability Standards
Prior service impairments
Reserve component
performing duty of 30 days
or less
DES Topics
Compensability Criteria
15-year rule for early
qualification for retired
pay for members of the
selected Reserve
Proximate result
Presumptions of service
incurred/aggravated and
overcoming presumptions
Conditions presumed to be
preexisting
Noncompliance (refusal of
treatment)
X
X
X
X
X
X
X
X
X
X
X
X
X
Patient
Administrators
PEB
Administrative
Action
Officers
X
PEBLOs/
Disability
Evaluation
Counselors
X
X
X
X
Physicians
Who
Write
Narrative
Summaries
Utopia Semibold
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Primary Participants
Medical
Evaluation
PEB
Medical
Board
Members/
EvaluaApproving Approving
tion Board
AuthorAuthorMembers
ities
ities
Table G.1—Continued
X
X
X
X
X
X
X
X
Post-PEB
Appellate
Review
Board
Members
X
X
X
X
X
X
X
X
Attorneys
Who
Represent
Service
Members
X
Active
Component
Unit
Commanders
X
X
X
X
Reserve
Component
Commanders
194
Improving Performance of the DoD Disability Evaluation System
Utopia
Adjudication of TDRL
reevaluations
TDRL Statutory
Requirements
Retired pay while on TDRL
remains constant at 50%
to 75% of base pay,
although rating may be
less
TDRL reevaluations
DES Topics
Range of Disability
Dispositions
Fit, return to duty
Unfit, separate with
severance pay
Unfit, separate without
disability benefits
Unfit, permanent disability
retirement
Unfit, temporary disability
retirement list
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Utopia Semibold
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
PEB
Administrative
Action
Officers
Primary Participants
Medical
Evaluation
PEB
Medical
Board
Members/
EvaluaApproving Approving
tion Board
AuthorAuthorMembers
ities
ities
X
X
Patient
Administrators
PEBLOs/
Disability
Evaluation
Counselors
Physicians
Who
Write
Narrative
Summaries
Table G.1—Continued
X
X
X
X
X
X
X
X
Post-PEB
Appellate
Review
Board
Members
X
X
X
X
X
X
X
X
Attorneys
Who
Represent
Service
Members
X
X
X
X
X
Active
Component
Unit
Commanders
X
X
X
X
X
X
Reserve
Component
Commanders
DES Training Topics for Primary Participant Populations Across Military Departments
195
Utopia
Medical evidence in case
adjudication
Fact versus opinion
Purpose of Medical
Evaluation Board
DES Topics
Medical Board Contents
Sufficient narrative
summaries
Appropriate specialty
consults
Comprehensive Clinical
Evaluation Protocol
LOD determinations (Notice
of Eligibility for Navy
Reserves)
Complete physical
examination (Standard
Form 88/93)
Appropriate signatures
Documents dated within last
90 days
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
PEB
Administrative
Action
Officers
X
X
X
Patient
Administrators
X
X
PEBLOs/
Disability
Evaluation
Counselors
X
X
X
X
X
X
X
X
X
Physicians
Who
Write
Narrative
Summaries
X
X
Utopia Semibold
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Primary Participants
Medical
Evaluation
PEB
Medical
Board
Members/
EvaluaApproving Approving
tion Board
AuthorAuthorMembers
ities
ities
X
X
X
X
X
X
Table G.1—Continued
X
X
X
X
X
X
X
X
X
Post-PEB
Appellate
Review
Board
Members
X
X
X
X
X
X
X
X
X
X
X
Attorneys
Who
Represent
Service
Members
X
X
X
X
X
Active
Component
Unit
Commanders
X
X
X
Reserve
Component
Commanders
196
Improving Performance of the DoD Disability Evaluation System
Utopia
How a service member gets
to a Medical Evaluation
Board
Composition (members) of
a Medical Evaluation
Board
Retention standards
considered by a Medical
Evaluation Board
Documentation of rationale
supporting Medical
Evaluation Board decision
DES Topics
Necessary Medical Data in
Sufficient Detail to Enable
PEBs to Adjudicate Cases
Migraine headache cases
Orthopedic cases (especially
backs )
Neurological/Neurosurgical
cases (especially backs)
Ophthalmologic cases
Pulmonary cases
Cardiological cases
Psychiatric cases (for
example, epilepsy,
narcolepsy)
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Patient
Administrators
X
PEBLOs/
Disability
Evaluation
Counselors
X
X
X
X
X
X
X
X
X
X
X
X
PEB
Administrative
Action
Officers
X
X
X
X
X
X
X
X
X
X
X
Physicians
Who
Write
Narrative
Summaries
X
Utopia Semibold
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Primary Participants
Medical
Evaluation
PEB
Medical
Board
Members/
EvaluaApproving Approving
tion Board
AuthorAuthorMembers
ities
ities
X
X
X
Table G.1—Continued
X
X
X
X
X
X
X
X
X
X
X
Post-PEB
Appellate
Review
Board
Members
X
X
X
X
X
X
X
X
X
X
X
X
Attorneys
Who
Represent
Service
Members
X
X
Active
Component
Unit
Commanders
X
Reserve
Component
Commanders
DES Training Topics for Primary Participant Populations Across Military Departments
197
Utopia
Commander’s Letter or
Nonmedical Assessment
Timely response
Judgment regarding how
condition impacts service
member’s ability to
perform duty
When Specialty Consults
Are Required for the
Following Conditions and
the Diagnostic Details
That Are Required
Fibromyalgia
Chronic Fatigue Syndrome
Gulf War Syndrome/
SWATO-related CCEP
Psychiatric diagnoses/NPT
testing for head injury
patients
HIV
DES Topics
Medical Evaluation Board
range of dispositions
Narrative summary
template (contents and
format)
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Patient
Administrators
X
PEBLOs/
Disability
Evaluation
Counselors
X
X
X
X
X
X
X
X
X
PEB
Administrative
Action
Officers
X
X
X
X
X
X
X
Physicians
Who
Write
Narrative
Summaries
X
Utopia Semibold
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Primary Participants
Medical
Evaluation
PEB
Medical
Board
Members/
EvaluaApproving Approving
tion Board
AuthorAuthorMembers
ities
ities
X
X
X
Table G.1—Continued
X
X
X
X
X
X
X
X
Post-PEB
Appellate
Review
Board
Members
X
X
X
X
X
X
X
X
X
Attorneys
Who
Represent
Service
Members
X
X
X
Active
Component
Unit
Commanders
X
X
X
Reserve
Component
Commanders
X
198
Improving Performance of the DoD Disability Evaluation System
Utopia
Accepted medical principals
Assignment limitation
codes/physical profiles
Appealing Medical
Evaluation Board
decisions
Organization of the VASRD
plus supplements
(currently 26) and
updates
Procedure for rating by
analogy; use of
hyphenated codes in
disability adjudication
Analogous codes (in DoDI
1332.39 and updates) that
supplement the VASRD
Military department
analogous codes that
supplement the VASRD
and DoDI
DES Topics
Judgment regarding service
member’s ability to deploy
Adverse actions pending
X
X
X
Utopia Semibold
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
PEB
Administrative
Action
Officers
X
Primary Participants
Medical
Evaluation
PEB
Medical
Board
Members/
EvaluaApproving Approving
tion Board
AuthorAuthorMembers
ities
ities
X
X
X
X
X
X
X
X
Patient
Administrators
X
PEBLOs/
Disability
Evaluation
Counselors
X
Physicians
Who
Write
Narrative
Summaries
Table G.1—Continued
X
X
X
X
X
X
Post-PEB
Appellate
Review
Board
Members
X
X
X
X
X
X
X
X
X
Attorneys
Who
Represent
Service
Members
X
X
X
Active
Component
Unit
Commanders
X
X
X
Reserve
Component
Commanders
X
DES Training Topics for Primary Participant Populations Across Military Departments
199
Utopia
DES Topics
What it would take to
increase percentage of
disability determined by
the PEB
Combined ratings/overall
effects
Bilateral factor
Pyramiding
Dual processing cases
Adjudication of cases
involving mental
disorders
Administrative
determinations for
purposes of employment
under federal civil service
Zero-percent ratings
Disability (separation and
retirement)
compensation
computation
Documentation of rationale
supporting PEB decision
Severance pay tax refund
Processing Reserve
component non-dutyrelated cases
Imminent death procedures
X
Utopia Semibold
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Patient
Administrators
PEB
Administrative
Action
Officers
Primary Participants
Medical
Evaluation
PEB
Medical
Board
Members/
EvaluaApproving Approving
tion Board
AuthorAuthorMembers
ities
ities
X
X
PEBLOs/
Disability
Evaluation
Counselors
X
Physicians
Who
Write
Narrative
Summaries
Table G.1—Continued
X
X
X
X
X
X
X
X
X
X
X
X
Post-PEB
Appellate
Review
Board
Members
X
X
X
X
X
X
X
X
X
X
X
X
X
Attorneys
Who
Represent
Service
Members
X
X
Active
Component
Unit
Commanders
X
X
X
Reserve
Component
Commanders
X
200
Improving Performance of the DoD Disability Evaluation System
Utopia
DES Topics
Formal PEB presentation
Final administrative
disposition of disability
separations and
retirements
Administrative finality
Appeal opportunities
Abuse of discretion
Template for managing
disability case appeal
Processing physicians and
general officers
Potential benefits from
the VA
Calculation of effective date
of separation or
retirement
Survivor benefit plan
Acronyms
Ready Reserves
Non-duty-related
impairment (Reserve
component)
Optimum medical
treatment benefits
X
X
Utopia Semibold
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
Attorneys
Who
Represent
Service
Members
X
X
X
X
X
X
Post-PEB
Appellate
Review
Board
Members
X
X
X
X
X
X
X
Primary Participants
Medical
Evaluation
PEB
Medical
Board
Members/
EvaluaApproving Approving
tion Board
AuthorAuthorMembers
ities
ities
X
X
X
Patient
Administrators
PEB
Administrative
Action
Officers
X
X
X
X
X
PEBLOs/
Disability
Evaluation
Counselors
X
X
Physicians
Who
Write
Narrative
Summaries
Table G.1—Continued
X
X
Active
Component
Unit
Commanders
X
X
X
X
X
Reserve
Component
Commanders
X
DES Training Topics for Primary Participant Populations Across Military Departments
201
Utopia
DES Topics
Preponderance of evidence
Administrative
determinations for federal
tax benefits
Natural progression
Presumption of fitness rule
and overcoming
presumptions
X
X
PEBLOs/
Disability
Evaluation
Counselors
X
X
Patient
Administrators
X
PEB
Administrative
Action
Officers
X
X
Physicians
Who
Write
Narrative
Summaries
X
Utopia Semibold
X
X
X
X
Primary Participants
Medical
Evaluation
PEB
Medical
Board
Members/
EvaluaApproving Approving
tion Board
AuthorAuthorMembers
ities
ities
X
X
X
X
Table G.1—Continued
X
X
Post-PEB
Appellate
Review
Board
Members
X
X
X
X
Attorneys
Who
Represent
Service
Members
X
X
Active
Component
Unit
Commanders
Reserve
Component
Commanders
202
Improving Performance of the DoD Disability Evaluation System