Medical Evaluation Boards

Title 10, U.S.C., chapter 61, provides the Secretaries of the Military Departments with authority to retire or separate members when the Secretary finds that they are unfit to perform their military duties because of physical disability. The functional proponent for the Physical Disability Evaluation System (PDES) is the U.S. Army Physical Disability Agency (USAPDA). The Subordinate Physical Evaluation Board (PEB) is located at USAPDA; Fort Sam Houston, Texas.
Your primary care doctor recommends a Medical Evaluation Board (MEB). Your case is referred to and evaluated by a Medical Board Physician who initiates a permanent profile if warranted. If a permanent 3 or 4 level profile is issued the Soldier will be contacted by a Physical Evaluation Board Liaison Officer (PEBLO). The Soldier is enrolled in the Integrated Disability Evaluation System (IDES) and an MEB is undertaken. During the MEB process the Soldier will be evaluated by the Veterans Administration and a VA liaison will also be assigned to assist with Soldier. The Soldier's packet is forwarded to the Physical Evaluation Board for a final decision. Once results are received, the Soldier is counseled on his/her elective options. The Medical Boards Section and the Integrated Disability Evaluation System (IDES) is located on the 3rd floor at the south end of Reynolds Army Health Clinic.

Counseling 

The individual responsible for counseling soldiers referred into the PDES with a MEB is the Military Treatment Facility (Reynold Army Health Clinic) Physical Evaluation Board Liaison Officer (PEBLO). The PEBLO counsels the soldier on MEB/PEB findings and related rights and benefits. If the MTF determines that the soldier is not mentally competent, the PEBLO counsels the designated next-of-kin. 

Fitness Standard 

The standard for determining fitness is whether the medical condition precludes the soldier from reasonably performing the duties of his or her office, grade, rank, or rating.

1. Worldwide deployability: Inability to perform the duties of office, grade, rank or rating in every geographic location and under every conceivable circumstance will not be the sole basis for a finding of unfitness. Deployability is a primary consideration in determining fitness.
2. Performance-based: The PDES relies heavily on the performance data provided by the soldier's immediate commander. Variance in case findings is often the result of inadequate information being provided relative to the soldier's duty performance.

Presumption of Fitness 

When a soldier is referred for physical disability evaluation after having applied for length of service retirement, or an officer is within twelve months of mandatory retirement, or an enlisted soldier is within 12 months of his or her retention control point with retirement eligibility, the soldier enters the disability system under the presumption that he or she is physically fit. This is known as the Presumption of Fitness Rule. (This rule is not applied to RC cases referred under the non-duty related process described at paragraph 2c(5) above.)

1. Philosophy: The soldier is presumed fit because he or she has continued to perform military duty up to the point of retirement for reasons other than physical disability. Disability retired pay is to compensate a soldier whose career is terminated solely for reasons of disability.
2. History: The presumption rule originated as DoD policy in 1973 as a result of Congressional dissatisfaction with general ranked officers and medical officers retiring for physical disability when they were eligible for length of service retirement.

 Overcoming the presumption 
Application of the Presumption of Fitness Rule does not mandate a finding of fit. It is a rebuttal presumption that is overcome if the preponderance of evidence establishes the circumstances described below per DOD Instruction 1332.38.

1. Acute, grave illness or injury: Within the presumptive period an acute, grave illness or injury occurs that would prevent the member from performing further duty if he or she were not retiring; or
2. Deterioration of a chronic condition: Within the presumptive period a serious deterioration of a previously diagnosed condition, to include a chronic condition, occurs and the deterioration would preclude further duty if the member were not retiring; or
3. Inadequate duty performance: The condition for which the member is referred is a chronic condition, and a preponderance of evidence establishes that the member was not performing duties befitting his or her experience in the office, grade, rank, or rating before entering the presumptive period.

Rating Schedule

Once a determination of physical unfitness is made, the VA will render a disability rating.

Periodic Medical Reexamination and Tenure

When placed on the Temporary Disability Retirement List (TDRL), the law requires the member to undergo a periodic medical reexamination within 18 months followed by PEB evaluation. The soldier may be retained on the TDRL or final determination may be made. While the law provides for a maximum tenure of 3 years on the TDRL, there is no entitlement to be retained for the entire period.

Factors affecting compensation

Military disability compensation is based on disposition, rank, and years of service.

1. Retired pay: For permanent retirement or placement on the TDRL, compensation is based on the higher of two computations:
   • Disability rating times retired pay base; or,
   • 2.5 x years of service x retired pay base.

Soldiers on the TDRL receive no less than 50% of their retired pay base. The definition of retired pay base depends upon when the soldier entered the service. For those who entered prior to 8 September 1980, it is the highest basic pay received. For those who entered after 7 September 1980, it is the average of the highest individual of 36 months of basic pay.

2. Severance pay: Disability severance pay equals 2 months basic pay for every year of service not to exceed 12 years.
3. Promotion selection: Soldiers who are to be retired for disability who are on a promotion list will be retired at the higher grade. However, for those soldiers who entered the military after 7 September 1980, the definition of retired pay base results in no impact on retired pay. Soldiers being separated for disability who are on a promotion list will receive increased severance pay, since it is based on the basic pay of the soldier's grade.