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33. PHYSICAL DISABILITY EVALUATION SYSTEM (PDES)/DES PILOT:

*NOTE: Upon arrival, each Warrior in Transition should be issued the Physical Disability Evaluation System Handheld Guide.

The medical board process is officially called the PDES, Physical Disability Evaluation System. A Warrior is directed to the PDES if they have a medical condition that fails to meet retention standards IAW AR 40-501, Chapter 3. The determination of failing to meet medical retention standards is made by a physician. Questions regarding the Medical Board System should be directed to your chain of command, case manager, or PEBLO. You should receive a pocket-size handbook on the PDES during in-processing.

A. Once a physician determines a Warrior has reached optimal medical care but still fails to meet retentions standards, they will refer the Warrior into the DES. This can be done through a referral form and/or a permanent profile with a "3" or "4" designator in the PULHES portion. This designation identifies the Warrior with significant limitations in their physical ability in that particular section. The referral or permanent profile is then forwarded to the PEBLO (Physical Evaluation Board Liaison Officer) who will contact the Warrior telephonically and arrange an appointment to start the Medical Evaluation Board (MEB) process. Warriors are required to attend a mandatory process briefing.

D. Under the new Pilot DES, the PEB at Walter Reed Army Medical Center will use the DVA physical exam worksheets, the NARSUM and DA Form 3947, along with other performance and administrative documentation to determine a Warrior's fitness or unfitness to continue military service. If the PEB finds the Warrior FIT because his/her medical condition does not affect their performance; does not create a risk for the Soldier; or place an undue burden on the unit, the Warrior will be returned to duty within the limits of their profile. If the

PEB finds the Warrior UNFIT to continue in the Army, and finds the Warrior is eligible for disability benefits, the PEB will inform the Soldier of their findings through their PEBLO, and request a disability rating from the DVA Rating Board. The DVA Rating Board will evaluate the Warrior's referred and claimed conditions and provide a rating percentage (with rationale) to the PEB within 15 calendar days. Once the PEB receives the DVA Rating Boards rating decision, the PEB will apply DVA's rating(s) to unfitting conditions, and recommend a final disposition. Final dispositions include: if found fit, the PEB will recommend the Warrior be returned to duty. If found UNFIT, the PEB may recommend one of the following if eligible for disability benefits: Separate with Severance Pay (SWSP); Permanent Disability Retirement (PDR); or that the Warrior be placed on the Temporary Disability Retirement List (TDRL). If found UNFIT, but NOT eligible to receive disability benefits, the PEB will recommend the Warrior be Separated without Benefits (SWOB).

E. The severity of the condition determines whether a Warrior, who is eligible for disability benefits, receives disability retirement or is separated with severance pay. Warriors rated with a 0, 10 or 20% disability who have less than 20 years of active service (or 7200 points of combined service) will be separated with severance pay. To compute disability severance pay, multiply the Warrior's basic pay for two months by the number of combined years (up to 19 years). Warriors with less than 3 years active duty time inservice will have their compensation calculated with a multiplier of 3 (unless they were injured in a combat theater in which case the multiplier will be 6). NOTE: There is no difference between a 0%, 10% or 20% rating in the calculation of the amount of severance pay that is received. The rating is NOT a factor in determining severance pay. Soldiers with 20 or more years of active military service or 7200 points of combined service, or possessing a combined disability rating of 30% or more, receive disability retirement. Disability retirement is either temporary or permanent depending on the stability of the Soldier's medical condition.

F. Warriors who qualify for permanent disability retirement (rated at 30% or higher or with 20 or more years of active duty or 7200 points of combined service) are placed on the TDRL if the PEB determines that their condition is not stable for rating purposes. This happens if, in the opinion of the PEB, the Warrior's condition can be expected to improve or worsen during the TDRL period. While on the TDRL, the disability rating doesn't change, regardless of any change in condition of the Warrior. Placement on the TDRL protects both the Warrior and the Army. Warriors placed on the TDRL will receive a minimum of 50% of basic pay (or high 36-month average as described earlier) and also receive all other retirement benefits (ID cards, TRICARE eligibility, etc.) while on the TDRL. Warriors on TDRL will receive a medical re-evaluation at least once every 18 months while on the TDRL, and this re-evaluation will be forwarded to a PEB for a new disability determination. As a result of the new PEB finding, the Warrior may be found fit (and may be given the opportunity to return to military service if desired), separated with severance pay (if the rating is decreased under 30%), permanently retired, or retained on the TDRL and re-evaluated again within 18 months. Placement on the TDRL cannot be longer than five years. At the end of those five years Warrior must be removed and given a final rating.

G. For those who are permanently retired for disability, disability retirement pay is computed on the basis of the actual disability rating (i.e., 30% disability rating) or the length of service rating (2.5 x years of service up to a maximum of 75%). The percentage is multiplied by the Soldier's basic pay (or high 36-month average as described earlier). Disability retired and severance pay awarded to Soldiers who were not a member of the armed forces on September 24, 1975 is considered taxable by the Internal Revenue Service (IRS). An exception exists for a Soldier receiving separation or retired pay by reason of a combat-related injury. The PEB will make combat-related determinations on all cases considered. The Warrior's grade for purposes of computing disability severance pay or retirement pay is the higher of the Warrior's current grade, highest grade satisfactorily held, or grade to which the Warrior was pending promotion. Enlisted Soldiers whose promotion eligibility date is after their separation date will be promoted on their last day of active duty. Officers pending promotion receive disability retirement or severance pay at the promotion list grade but, under officer promotion law, cannot be promoted ahead of their promotion eligibility date.

H. The PEB will also determine if the medical condition was combat related or caused by an instrumentality of war.

I. Warriors can be Separated Without Benefits (SWOB) under the following situations: (1) the unfitting conditions result from injury which is due to intentional misconduct or willful neglect; (2) the disability was incurred during a period of unauthorized absence; (3) the disability was not incurred or aggravated as the proximate result of performing duty (for example EPTS-Existed Prior to Service). Physical or mental disabilities that make a Warrior unfit may have existed prior to entering the service (EPTS). Causes of EPTS disabilities include hereditary or congenital defects or injuries with an inception before entering active service. There is a presumption that pre-existing conditions have been service-aggravated, but this presumption can be overcome if the PEB determines that the worsening of any condition followed the "natural progression" of the pre-existing injury or disease based on well-established medical principles. If a Warrior has less than eight years total active service, he/she could be separated from the service without disability benefits. This would happen if the PEB deems a Warrior's injuries EPTS and his/her condition has not been permanently aggravated by military service. By law, the Army only compensates for those conditions that were caused by, or permanently aggravated as a result of, military service. It is possible for a Warrior to possess a physical or mental disability and never experience a problem until he/she faces the stresses of military life. The physical and emotional stress of military training can cause a latent condition to appear or an old injury to worsen to the point that the Soldier is no longer able to perform his/her military duties. To appeal a finding of EPTS, a Soldier must present medical evidence that the condition did not exist prior to entering the service, or provide medical evidence documenting that military service permanently aggravated a pre-existing condition.

J. The PEB will forward its findings to the PEBLOS. In accordance with DOD Directive Type Memorandum, SUBJECT: Policy and Procedural Directive-Type Memorandum (DTM) for the Disability Evaluation System (DES) Pilot Program, dated 21 November 2007, the Warrior has 5 working days from receipt of notification from the PEB to return the election statement. If the election statement is not returned to the PEB within the prescribed time, the Warrior is presumed to agree with the PEB recommendation and the case is forwarded to the PDA for final processing. Choices for election of PEB findings:

(1) CONCUR (AGREE) and WAIVE a FORMAL board evaluation.

- Warrior agrees with the informal board findings and does not want the case presented for formal board proceedings.

- Case is processed by the PEB for return to duty, separation, or retirement, depending upon the informal board recommendations.

(2) NONCONCUR (DISAGREE) and DEMAND a FORMAL board evaluation.

- Warrior disagrees with the findings of the informal board and wants the case presented to a formal board. The Warrior may elect to NOT PERSONALLY APPEAR and have the case presented by legal counsel or to PERSONALLY APPEAR at the formal board.

- The Warrior has the right to legal representation. The purpose of legal counsel is to ensure that the Warrior's rights are protected and that all relevant medical and administrative facts concerning the case are presented to the board.

- The formal board is a fact-finding board and will consider the case independently of the informal board. The formal board may adhere to the original informal board, or change the findings and recommendations.

(3) The Warrior can also NONCONCUR with his/her DVA ratings and request a one time reconsideration of the ratings prior to his/her separation.

After beginning the MEB, Warriors should refer any questions about the DES to their PEBLO.