2013 Understanding the Findings of the Integrated Disability Evaluation System WWR PEB Liaison Mr. Dean Trio Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Terminal Learning Objectives 2 As an RCC help Marines and families… Prevent Delays Reduce Frustration Achieve the Best Possible Outcome Prepare the Marine for his meeting with the PEBLO so he can easily absorb the information presented Provide basic factual information about IDES and ensure the Marine understands the terminology Educate the Marine on the implications of the various IDES dispositions as well as the VA and DoD ratings. Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Enabling Learning Objectives 3 Identify the significance of the information presented to the Marine in the Findings of the Physical Evaluation Board Proceedings • Findings section (Finding, Disposition, Disability Rating) • Diagnoses and Rating (Categories, Ratings, Combat Codes) • Additional Findings Identify the significance of the information presented to the Marine in the VA Decision Letter • • • • • Service-connectedness Rating Future routine exams List of Evidence Reason a higher rating was not proposed Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Enabling Learning Objectives (2) 4 Identify the options presented to a Marine who is found unfit Discuss the ramification of accepting unconditionally if the Marine is recommended for: • TDRL • PDRL • Separation with Benefits Recognize the appropriate way to contest each type of determination: • Finding of Fit / Unfit for any condition • Rating assigned to any condition • Combat Code assigned to any condition Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Rules of the Road 5 Prepare the Marine for what to expect when the PEBLO counsels him on his preliminary findings Encourage the Marine to consult an IDES attorney before accepting the findings Discuss PLD with the Marine before his findings are presented Help the Marine understand the options available to him for contesting various findings by the VA and the PEB Agree or disagree if a Marine expresses that he has been “screwed by the system” Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Findings of the Physical Evaluation Board Proceedings 6 DEPARTMENT OF DEFENSE Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome 7 INFORMAL Date Printed DD MMM YYYY When the PEBLO presents the proposed findings to the Marine, the PEBLO presents the Marine with the form pictured here. 1. Name SUNLEY, Neil S Ref# xxxxxxxxxxx Findings of the Physical Evaluation Board Proceedings 2. SSN xxx-xx-xxxx PERSONNEL DATA 3. Rate/Rank 4. Service CPL USMC 5. MOS 3043 Page 1 6. LOS X yrs. Y mos. PHYSICAL EVALUATION BOARD 7. The Board convened at: NCPB, Washington DC, dd mmm yyyy to consider the MedBoard originated at: City, State Board Membership Consisted of: Va-DRO, USN, Officer Va-DRO, USN, Officer Va-DRO, USN, Officer FINDINGS 8. Finding Unfit 9. Recommended Disposition Permanent Disability Retirement from Active Duty 10. Combined Disability Rating 70% DIAGNOSES AND RATINGS Category I: Unfitting Conditions Marines should know what to look for when they review the form. Disability Rating or VA Diagnostic Codes Reason if not rated 1. PTSD* CR(AC) (cz vat) 9411 50% 50% 2. Asthma* 6602 30% 30% Category III: Conditions that are not separately unfitting and do not contribute to the unfitting condition(s) 3. Erectile Dysfunction 11. A. B. C. D. ADDITIONAL FINDINGS The disability was incurred while entitled to receive basic pay. The disability did not occur during a period of unauthorized absence The disability is not the result of intentional misconduct or willful neglect The disability did occur after 14 Sep 1978 12. The disability is permanent 13. A. The disability was the direct result of a combat related injury as defined by Title 26 U.S. Code Section 104(b)(3) B. The board finds further that the disability was incurred in the line of duty as the result of armed conflict Consultation with an IDES attorney is always encouraged. 14. All board members concurred NO SIGNATURE - SAMPLE DOCUMENT Click image to see sample findings in full screen Boxes 8-10 reflect the proposed finding, disposition and rating Each condition is categorized and rated separately; normally, if a condition is in Category I (Unfitting Conditions) the Disability Rating will be the same as the VA rating The additional determinations made by the PEB are included in Additional findings – these can affect a range of benefits Findings of the Physical Evaluation Board Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Findings Section 8 Determines whether Marine will be returned to full duty If found unfit, the Marine will be separated if Combined Disability Rating < 30% If found unfit and Combined Disability Rating >= 30% Marine will be transferred to the TDRL if one of the unfitting conditions is not permanent Combined Disability Rating will determine the Recommended Disposition as well as the projected retirement benefits Box 8 Findings Box 9 Recommended Disposition Box 10 Combined Disability Rating •Fit – if there are no unfitting conditions •Unfit – if there is one or more unfitting conditions •Return to Full Duty – Fit •Separate without Benefits – Unfit, 0% •Separate with Benefits – Unfit, 10-20% •Temporary Disability Retirement – Unfit, 30%100%, one or more conditions that are not permanent •Permanent Disability Retirement – Unfit, 30%100%, all unfitting conditions are permanent •0% - 100% - Ratings for all Unfitting Conditions are combined using VA Rating Charts (this is not simple addition) The Findings Section is based entirely on the sections which follow– Diagnoses and Ratings and Additional Findings Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Diagnoses and Ratings Section 9 The PEB considers each condition separately The PEB is not required to even consider any condition that was not referred, even if it was listed on the VA Claim Form by the Marine • The PEB does have the authority to consider additional conditions rated by the VA, but does not do so routinely • The Marine can NOT demand a Formal Board to have such conditions considered Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Categorization of Findings 10 Each of the conditions referred to the PEB will be categorized individually: Category Title Factored into DoD Disability Rating? Category I Unfitting Conditions Yes Category II Conditions That Are Contributing to the Unfitting Condition(s) No Category III Conditions That Are Not Separately Unfitting, and Do Not Contribute to The Unfitting Condition No Category IV Conditions Which Do Not Constitute a Physical Disability No • • Marines can DEMAND a formal board to contest a finding of Unfit (i.e., category I) Marines can REQUEST a reconsideration or Formal Board (based on NEW evidence) to contest a finding of Fit (i.e., Category II, Category III or Category IV) Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Additional Findings Paragraphs 11 Basic Pay • Was the disability incurred or aggravated while entitled to receive basic pay? Misconduct • Was the disability the result of intentional misconduct or willful neglect? • Whether the disability was incurred during a period of unauthorized absence? Miscellaneous • Disability is the proximate result of active duty or inactive-duty training, or • Disability was incurred in line of duty in time of war or national emergency, or • Disability was incurred or aggravated after 24 September 1975 Permanence Ratable • Disability is permanent, or • Disability may be permanent • Is the disability ratable in accordance with VA and DoD regulations • Note: Conditions which are determined to be pre-existing may be considered not-ratable but can still be unfitting (will result in Separation w/o Benefits) Each of these findings are normally found in paragraphs 11 and 12 of the “Additional Findings” area of Page 1 of the Findings of the Physical Evaluation Board Proceedings. However, while the PEB must make these determinations they are not required to publish them to the Marine. Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Finding must be yes to receive disability compensation Finding must be no to receive disability compensation Finding determines whether the Recommended Disposition for a Marine found Unfit will be TDRL or PDRL Combat Codes 12 The PEB may also make a determination whether a condition is combat related. If they do so they will apply the appropriate combat code to each relevant condition and state this in Additional Findings: Abbrv* Combat Code Disability qualifies for CRSC Disability / Severance Tax Exempt Severance Exempt from VA Recoupment Eligible for EPLD CZ In a combat zone No Case by case Case by case Not Eligible CR(AC) Direct Result of Armed Conflict Yes Exempt Exempt Eligible CR(IW) Instrumentality of War Yes Exempt Exempt Not Eligible CR(SW) Simulation of War Yes Exempt Exempt Not Eligible CR(HZ) Hazardous Duty Yes Exempt Exempt Not Eligible *The abbreviations listed are the most commonly used; however several alternative abbreviations may be seen (such as HD for Hazardous Duty) A Marine can not request a Formal Board to challenge the combat code (or lack thereof). Rather, the Marine appeals through OJAG (Code 13), either immediately or in veteran status Criteria for each combat code can be found in the instructions for DD Form 2860, Application for CRSC Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome VA Decision Letter 13 Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Conditions Rated Separately 14 Every referred and claimed condition should be addressed separately and specifically in the VA Decision Letter The conditions will be presented in three groups: Both of these groups • Unfitting conditions related to military service count towards the VA • Claimed conditions related to military service Disability Compensation aware. Although unfitting • Claimed conditions not related to military service conditions are presented The final group is the conditions that were denied; these will not receive a rating and will not affect the VA Disability Compensation separately, the determination that a condition was unfitting is actually made by the PEB Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Conditions Related to Military Service 15 GROUP I: Unfitting Conditions We are proposing that the following unfitting conditions are related to your military service, i.e., service connected: Medical Description Evaluation EXERCISE INDUCED ASTHMA (ALSO DIAGNOSED AND CLAIMED AS ASTHMA) 30% Unfitting conditions are presented in a table introduced by this heading This is the rating for this condition Please Note: You will be scheduled for a routine future exam for this condition 2 years after you are discharged from military service Not every condition requires a future exam, however, when one will be required it will be noted here. The proposed combined rating for your unfitting conditions is 30%: The rating agency may determine that the condition claimed (in this case “Asthma”) should actually have been claimed as a similar or related condition, (in this case “Exercise Induced Asthma”). If so, this is how it will appear DoD Rating This should correspond to the Combined Disability Rating on the Findings of the Physical Evaluation Board. This future VA exam is distinct from any Periodic Physical Examination required by the DoD for Marines on TDRL. The VA exam will only affect the VA Rating Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Conditions Related to Military Service 16 GROUP II: Service-connected Claimed Conditions We are proposing that the following claimed conditions are related to your military service, i.e., service connected: Medical Description Evaluation RIGHT ELBOW CONTUSION, RESOLVING {DOMINANT EXTREMITY} (ALSO DIAGNOSED AND CLAIMED AS RIGHT ELBOW PAIN) 0% This is the heading for Service Connected Claimed conditions (Group II) There is NO additional language between Group II and Group III unless Special Monthly Compensations are awarded Obtaining a rating of 0% is a better result than having a diagnoses not acknowledged. The service-connectedness of this condition has been acknowledged by the Government. If the condition is aggravated, the Marine may become eligible for compensation in the future. Once the Marine leaves active duty establishing service connectedness is much more difficult. Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome This is the rating for this condition When the VA does not indicate that a “routine future exam” will be scheduled, the onus is on the Marine to schedule an exam if the condition worsens Conditions Not Related to Military Service 17 GROUP III: Not Service Connected We are proposing that the following claimed conditions are not related to your military service, i.e., are not service connected: Medical Description Reason & Rationale RIGHT ANKLE SPRAIN The evidence does not show a current diagnosed disability. While your service treatment records reflect complaints, treatment, or a diagnosis similar to that claimed, the medical evidence supports the conclusion that a persistent disability was not present in service We are proposing that the total combined rating for unfitting and claimed service-connected disabilities is 30% VA Rating This rating reflects the combination of disabilities identified in Group I and Group II The claimed conditions that were denied are presented under this heading At a minimum the Reason & Rationale will let you know if the condition was determined to not be a disability (as in the example) or whether it was found to be a disability that is not service connected Often, the Reason & Rationale is largely boilerplate that provides little in the way of explanation Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome 18 Potential Entitlements After the Proposed Ratings and before the Evidence and Reasons there will be a section of possible benefits. The first paragraph is individualized and puts in dollar figures the VA compensation that is being proposed. Although presented as an estimate this merely protects the Government in case of a clerical error. We estimate that if the proposed In this section the Marine will find the actual dollars of VA compensation being proposed. This figure is based on the VA Rating found earlier, any special monthly compensations found earlier, the Marines family structure and the current pay table. ratings are adopted, you may be entitled after discharge from service to monthly VA compensation in the amount of $XXXX.CC based on the current statutory rates of disability compensation. This estimate is based on paying you as a single veteran with no dependents… Everything that follows this paragraph is usually boilerplate – i.e., the pages on Home Loan Guaranty, Voc Rehab, Medical Care, Clothing Allowance, etc. are provided to all Marines with no effort made to determine if they are eligible. Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome 19 Evidence The evidence relied upon to make the rating decision is listed here Check the list to make sure exams or other records that were submitted to the PEBLO are all accounted for EVIDENCE VA examination (General Medical), Gainesville, FL VAMC, dated May 3, 2013 VA examination (Initial PTSD), Gainesville, FL VAMC, dated May 8, 2013 VA Form 21-0819, VA/DOD Joint Disability Evaluation Board Claim received February 17, 2013 VCAA Pre-Discharge Notice Response dated February 17, 2013 Physical Evaluation Board Proceedings dated July 2, 2013 Joint DOD/VA Disability Evaluation Pilot Referral dated February 10, 2013 Medical Evaluation Board Proceedings dated June 14, 2013 Commanders Performance and Functional Statement (Nonmedical Assessment) dated June 5, 2013 Service treatment records from March 15, 2001 through February 17, 2013 Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome 20 REASONS FOR DECISION 1. Evaluation of exercise induced asthma (also diagnosed and claimed as asthma) for Disability Evaluation System purposes and proposed entitlement to service connection for Department of Veterans Affairs (VA) benefits. How the VA Decides Each condition that was found to be service connected will be listed in a section titled “Reasons for Decision” Zero in on whatever comes after the word unless. The key to a ratings reconsideration is providing new evidence that directly addresses this standard Service connection for exercise induced asthma (also diagnosed and claimed as asthma) is proposed as directly related to military service. We have proposed a 30 percent evaluation for your asthma, bronchial based on: Daily oral bronchodilator therapy Inhalational anti-inflammatory medication A higher evaluation of 60 percent is not warranted unless there is: Forced Expiratory Volume in One Second (FEV-1) of 40 to 55 percent predicted; or, FEB-1 to Forced Vital Capacity (FEB-1/FVC) of 40 to 55 percent; or At least monthly visits to a physician for required care of exacerbations; or, Intermittent (at least three per year) courses of systemic (oral or parenteral) corticosteroids Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Marines Found Unfit 21 THE OPTIONS PRESENTED TO A MARINE WHO IS FOUND UNFIT BY THE PEB Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome The Marine’s Three Options 22 Accept Findings • Accept unconditionally and be separated or retired as per the final disposition of the finding Formal PEB • Demand a Formal PEB and appear in person to rebut the preliminary findings with assigned legal counsel (if desired) Conditionally Accept • Conditionally accept the findings on stated conditions subject to approval of higher authority Findings Presented PEBLO Counsels The findings will be presented to the Marine in writing; they can be The PEBLO is required to delivered in person, by mail, counsel the Marine as soon or by fax / email. as practicable after the findings have been delivered. When the Marine is located at a major installation it is usually done on the same day. Marine Makes Decision The Marine has 10 days to make a decision. The 10 days begin from the date the Marine receives the findings not the counseling. Marines may feel pressure to sign immediately. Implications vary based on Recommended Disposition. See following slides. Click to See Election Usually used to of Options Form request PLD If the 10 days expire, the PEB will begin to implement the Recommended Disposition as a Presumed Unconditional Acceptance. In this case, the Marine can still demand a Formal Board (until discharged). However, he can no longer accept conditionally or request PLD Marines should be prepared when they meet with the PEBLO. They should understand their right to counsel and have already considered PLD Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Options when Recommended for TDRL 23 All Marines should be encouraged to consult with an IDES attorney before accepting their findings Disposition DoD VA Accept Unconditionally • Marine will NOT be able to request PLD or EPLD • Conditions that were found to be notunfitting will not be reevaluated by the DoD in the future. • Conditions that were not referred to the MEB will not be considered in the future • Conditions that were found to be unfitting will be reevaluated during Periodic Physical Examinations and the final disposition may be adjusted accordingly – see TDRL training • The VA will reexamine those conditions identified as requiring “routine future exams;” the rating may be adjusted accordingly • The Marine may submit claims for any condition that was not claimed in the IDES at any time • The Marine may request reconsideration of any condition that was claimed in the IDES at any time to establish service-connectedness or receive a higher rating • The Marine may request Special Monthly Compensation at any time Formal Board • Marine will remain on active duty pending the Formal Board • No compensation will be paid until the results of the Formal Board are finalized and the Marine is discharged Conditional Acceptance • Normally used to request PLD • No compensation will be paid until the results of the Formal Board are finalized and the Marine is discharged Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Options when Recommended for PDRL 24 All Marines should be encouraged to consult with an IDES attorney before accepting their findings Disposition DoD VA Accept Unconditionally • Marine will NOT be able to request PLD or EPLD • The Marine’s DoD rating will not change • The VA will reexamine those conditions identified as requiring “routine future exams;” the rating may be adjusted accordingly • The Marine may submit claims for any condition that was not claimed in the IDES at any time • The Marine may request reconsideration of any condition that was claimed in the IDES at any time to establish service-connectedness or receive a higher rating • The Marine may request Special Monthly Compensation at any time Formal Board • Marine will remain on active duty pending the Formal Board • No compensation will be paid until the results of the Formal Board are finalized and the Marine is discharged Conditional Acceptance • Normally used to request PLD • No compensation will be paid until the results of the Formal Board are finalized and the Marine is discharged Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Options: Severance with Benefits 25 All Marines should be encouraged to consult with an IDES attorney before accepting their findings Disposition DoD VA Accept Unconditionally • Marine will NOT be able to request PLD or EPLD • The Marine’s DoD rating will not change • The Marine will not be eligible for: • TRICARE • SBP • Retired ID Card • If the Marine does not have the relevant combat code he can appeal to OJAG (Code 13) at any time • The VA will reexamine those conditions identified as requiring “routine future exams;” the rating may be adjusted accordingly • The Marine may submit claims for any condition that was not claimed in the IDES at any time • The Marine may request reconsideration of any condition that was claimed in the IDES at any time to establish serviceconnectedness or receive a higher rating • The Marine may request Special Monthly Compensation at any time • VA Benefits will be partially withheld to recoup the Marine’s Military Severance Pay until the Severance Pay is fully recouped unless a combat code of AC, HS, IW, or SW has been given Formal Board • Marine will remain on active duty pending the Formal Board • No compensation will be paid until the results of the Formal Board are finalized, the Marine is discharged, and the DD 214 has been provided to D-RAS Providence Conditional Acceptance • Normally used to request PLD • No compensation will be paid until the results of the Formal Board are finalized, the Marine is discharged, and the DD 214 has been provided to D-RAS Providence Although the Marine is not eligible for TRICARE permanently he can receive 180 days of medical coverage through TAMP Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Contesting the Findings 26 Marine Disagrees with Finding that… Actions Marine Can Take A referred condition was found unfitting by the PEB DEMAND a Formal Board A referred condition was found not to be unfitting by the PEB Request a reconsideration based on new evidence, and/or Request a Formal Board TDRL is appropriate because at least one unfitting condition is not stabilized No immediate reconsideration possible - PEB will reconsider at each Periodic Physical Examination while Marine is on TDRL – Further support through DISC / WWCC An unfitting or claimed condition was not determined to be combat related Appeal through OJAG (Code 13), or Provide other supporting documents when applying for CRSC A condition that is unfitting was rated lower than the Marine believes is appropriate Request Rating Reconsideration from the VA before accepting findings A service-connected but not unfitting condition was rated lower than the Marine believes is appropriate Request reconsideration from the VA after separation or retirement – VSO Referral highly suggested A condition was found to be service-connected by the VA, but it was not found to be unfitting by the PEB and the Marine believes it was rated too low Must follow the guidance for #2 above first; then based on that outcome either follow #5 or #6 A condition was found to be neither unfitting nor serviceconnected Request reconsideration from the VA after separation or retirement – VSO Referral highly suggested Marines should always meet with an IDES attorney to discuss their options A Marine who accepts his findings unconditionally waives the right to request PLD Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Multiple Conditions 27 Scenario: Sgt Williams was referred to the PEB for two conditions, and the Findings of the Physical Evaluation Board Proceedings (Informal) are presented below: Condition Findings PTSD Category I: Unfitting Conditions Lumbar and Thoracic Spine Strain Category III: Condition that is not unfitting and does not contribute to the unfitting condition(s) Note: In the additional findings section the PEB states the disabilities are not combat related If Sgt Williams disagrees with the finding that his PTSD is unfitting… • He can DEMAND a Formal Board If Sgt Williams disagrees with the finding that his spine strain is not unfitting… • He can REQUEST a reconsideration (based on NEW evidence) or a Formal Board If Sgt Williams believes that the PTSD was the direct result of armed conflict… • He can APPEAL the finding to OJAG (Code 13), or • He can submit other documentation when applying for CRSC Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Common Pitfalls IDES Findings Discussion: How can an RCC help avoid these pitfalls? • When a Marine is counseled by the PEBLO it feels like an overwhelming amount of information and he accepts the findings without understanding them • A Marine is upset by his low ratings and can not discuss his options rationally • A Marine is confused about the difference between unfitting and service-connected disabilities and doesn’t understand why he is not being medically retired 28 Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Resources 29 Basic Resources Advanced Resources IDES Consultation Class Formerly known as “DTAP” PLD is covered Wounded Warrior Regiment PEB Liaison Dean Trio 703-432-1856 RCC IDES Handbook Companion to MegaLink sheets http://www.rcckit.com/policy IDES Attorneys POC varies by location WWR External Fact Sheet https://ehqmc.usmc.mil/sites/wwr/wrc/External%20F act%20Slick%20Sheets/Integrated%20Disability%20Ev auation%20System%20slick%20sheet.pdf Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Knowledge Check 30 Cpl Diaz was presented his findings by the PEBLO and is unsure of whether he should accept the findings or not. Who is the best person to help him understand the findings and his options? His commanding officer An OIF/OEF Coordinator An IDES attorney A Federal Recovery Coordinator Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Knowledge Check 31 Can a Marine request the VA reconsider the rating given to a condition that is service-connected but found to be not-unfitting while he is still on active duty? No, the decision is final Only if he first requests a reconsideration by the DoD and / or a Formal Board and the PEB changes its determination and the condition is now considered unfitting No, although he can ask the VA to reconsider the rating after discharge Yes Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Knowledge Check 32 LCpl Alvorado was transferred to the PDRL as the result of one unfitting condition which the PEB determined was the result of an Instrument of War (Combat Code: IW). Which of the following are true? She is eligible to apply for EPLD She is eligible for CRSC Any Military Retired Pay that is not offset by VA Disability Compensation will be tax exempt She is eligible for a Purple Heart A and B only A and C only B and C only B, C, and D only All of the above Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Knowledge Check 33 GySgt Kleck was referred to the IDES for both PTSD and Tinnitus. In which of the following circumstances can he DEMAND a Formal Board? Both conditions are found to be unfitting and he wants to be found Fit for Duty The PTSD is found unfitting, the tinnitus is found to be not-unfitting and he wants the PTSD decision reversed so he can be found Fit for Duty The PTSD is found unfitting, the tinnitus is found to be not-unfitting and he wants to provide new medical evidence so the tinnitus will be found unfitting and his DoD rating will increase Both conditions are found to be not-unfitting and he does not want to be returned to duty A only A and B only A and D only C and D only All of the above Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Knowledge Check 34 SSgt Buckhantz lives in a remote and isolated location. His PEBLO faxes his findings to him on 1 July 2013 and schedules a telephone consultation on 5 July 2013. After the counseling the Marine is unsure of what he wants to do. How long does he have to make a decision? 10 calendar days from 1 July, the day he received the findings 10 calendar days from 5 July, the day he received his counseling 10 business days (i.e., two weeks) from 1 July the day he received his findings 10 business days (i.e., two weeks) from 5 July, the day he received his counseling Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Knowledge Check 35 PFC Clumber was referred to the IDES for only one condition – an anxiety disorder. He had no other claimed conditions. He was found unfit and the PEB determined that his disability “may be permanent.” Accordingly he will be transferred to the TDRL. He agrees with the rating, but does not think he needs to be reevaluated. How can he contest the finding that the condition “may be permanent.” By requesting a Formal Board By demanding a Formal Board By requesting a VA Rating Reconsideration By appealing to OJAG (Code 13) A only B and D only A and C only None of the above All of the above Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Knowledge Check 36 The ratings for the conditions in which of the following Categories on the Findings of the Physical Evaluation Board are used to calculate the Combined Disability Rating for the DoD? Category I: Unfitting Conditions Category II: Conditions that are contributing to the unfitting conditions Category III: Conditions that are not separately unfitting and do not contribute to the unfitting conditions Category IV: Conditions which do not constitute a physical disability A only A and B only A, B, and C only A, B, and D only D only Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Knowledge Check 37 Which of the following combat codes precludes the VA from withholding a portion of a Marine’s VA Disability Compensation to recoup a Military Severance payment? Armed Conflict (AC) Hazardous Service (HS) Instrument of War (IW) Simulation of War (SW) A only B only C only D only All of the above Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Knowledge Check 38 Sgt Martell’s VA Decision Letter states that he will be scheduled for a “routine future exam” to reconsider his Left Shoulder Dislocation. The PEB categorized this injury as an unfitting condition, but found that the disability was permanent and recommended transfer to the PDRL. Sgt Martell accepts the findings. When he attends the “routine future exam” at the VA which of the following are possible outcomes? His DoD Rating will go up His DoD Rating will go down His VA Rating will go up His VA Rating will go down A only A and B only A and C only B and D only C and D only Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome Questions 39 Prevent Delays ♦ Reduce Frustration ♦ Achieve the Best Possible Outcome