Beware the IDES of Medical Boards…?

This week we’re going to talk about a very confusing topic.  For this reason, I’m going to break this into several pieces so it’s – hopefully – easier to understand.  I’m going to talk about the Integrated Disability Evaluation System or, at least as we call it in the Army, IDES (pronounced eye-dez).

By the way, don’t be afraid of the title of this article.  I chose that name simply as a play on “Beware the ides of March” from Richard Shakespeare’s Julius Caesar.  You shouldn’t be afraid of IDES and medical boards.  You should understand it and know how to use it to benefit you.  I hope to help you do this.

I will confess to a bit of insider knowledge on a lot of what I’m about to mention because I’m currently going through IDES myself.  Anyway, IDES is the series of medical boards you go through when you have medical problems which just won’t heal (like for more than twelve months).  Of course, the military would like for you to recover and continue to be an asset.  If this just isn’t going to happen, these medical boards may be the best option for you.  Don’t be afraid of them.  Even though separation and / or retirement is a possibility, there is still the chance of being determined to be fit for duty and continuing service.  If this continued service is not what happens for you, there are other ways to continue service if you choose to do so.

Let’s describe what happens when you start the down the path of the Integrated Disability Evaluation System.  First of all, integrated what?  Very simple.  IDES is a joint evaluation by both your branch of service and the Department of Veterans Affairs (VA).  This means you walk away with disability ratings from both agencies when you are finished.  These ratings are independent of each other; by that I mean each agency has its own standards for determining a rating.

As an example of what I mean by independent standards, your branch of service is concerned about the medical issues which inhibit you from performing your military duties and whether or not the injuries were caused by your military service.  Let’s say you’re an infantryman who has back issues which make it very painful for you to wear a rucksack and conduct a road march.  This would be quite a problem for an infantryman but might not be as important if you’re an office worker.  The VA would rate your disability either way but your branch of service (BOS) will only look at whether or not you can still do your job (including fitness tests and height / weight standards, of course).  The ratings from these two agencies can vary considerably as a result.  Just a while ago, in fact, I had one person talking to me who had a forty percent rating from the Army but a ninety percent rating from the VA.

Treatment and Referral
Anyway, you have at this point suffered through your medical issues and finally informed your BOS of them.  The BOS has conducted what is called a fit-for-duty board and determined that you are unfit for continued service.  You will receive at this point a letter called a Medical Retention Decision Point (MRDP) memo.  This letter will inform you of your status and give you three options.  Those options are:

  1. Separation from the military.
  2. Retirement or transfer to the Retired Reserve (if eligible).
  3. Requesting evaluation by IDES.

You will then have a set amount of time to make a choice from the options shown above.

 

But, DJ, what is the best choice for me?

This is something only you can determine.  Naturally, you can seek advice from retirement services officers and other professionals but you will ultimate have to be the one to decide.  In my experience, many service members have benefitted from going through IDES. There have been just as many whose injuries were not duty-related (not caused by military service) and would not benefit from IDES at all.

Claim Development

Now you have chosen to dive into IDES.  You should request this through your chain of command and begin to prepare by requesting all of your medical records.  When I say all, I do mean ALL of them and from all sources.  Since the VA is going to look at everything you give them, it is best to have it readily available.  Your BOS will want to see just those records which pertain to your service-connected injuries.  You may need to hand carry your records to your first meeting with your case manager.

Everyone is assigned a case manager called a Physical Evaluation Board Liaison Officer (PEBLO).  This person is the link between you, your commander, and the IDES. Your PEBLO will be responsible for the military side of things and will counsel you on expectations and benefits as you travel down this path.  You will also be assigned a Military Service Coordinator (MSC) who will be responsible for the VA side of things (more on him in a moment).

Note: I recommend verifying what you are told by a PEBLO with a retirement services officer.  In my experience, PEBLOs have given “hit-or-miss” advice to service members.  This is not to bash them.  Often they are active duty-centric and as a result of their lacking sufficient experience with reserve component members end up giving them mediocre or even incorrect advice.  MSCs can have this same problem (such as the one who spoke with me; it was obvious he was talking from an active duty standpoint and counsel which would be correct for someone on active duty but incorrect for a reservist).  Again, I’m not trying to flame these people.  I’m just telling you to seek additional information.

Your PEBLO will give you an initial counseling of what to expect from IDES and assist you in completing a list of all medical issues which limit or prevent you from completing your military duties.  You will then be referred to your Military Service Coordinator.  By the way, neither of these people are employees of the IDES.  They are employees of the Military Treatment Facility (in the case of the PEBLO) and the VA (for the MSC).

The MSC will talk to you about the VA examinations and will compile a list of ALL of the issues you may have (or wish to claim) which have been caused by or exacerbated by your service.  Your PEBLO and MSC will then coordinate all of the specialist examinations you will need for the next phase of IDES.

Medical Evaluation

You will now be evaluated by physicians and specialists to determine the extent of your injuries (this includes mental conditions, such as Post-Traumatic Stress Disorder, as well). You are expected to make all of your appointments without fail.  Your chain of command will be notified if you do not show up to an appointment.

Expect this phase to take a month or two to complete.  Don’t get frustrated by the timeline.  Also remember that results of these exams will be provided to both your BOS and to the VA for independent ratings evaluation.

Medical Evaluation Board

Your documentation and exam results will now be reviewed by at least two physicians who will determine if you are fit to return to duty or if you do not meet medical retention standards.  If you do not, you will be referred to the next stage, the Physical Evaluation Board.

The Informal Physical Evaluation Board

This panel is made up of a three-member board of officers and civilians (often with military experience) and a civilian physician. PEBs involving reservists will have a reserve component member on the board.  The PEB will develop written justification supporting each injury you have sustained as far as whether it is preventing you from performing your military duties and whether it was sustained in a combat zone (which is important in a variety of ways).  If your conditions existed prior to your military service, they will also determine whether it was exacerbated (made worse) by your service.  They will decide whether the condition is permanent or temporary.  Lastly, they will determine whether a disability rating is warranted for that injury.

Remember that IDES is a performance-based review.  It is concerned with your ability to do your job and not – as is so often said by barracks lawyers – whether you are deployable or not (though that could be a factor for some specialties like infantry).

The Combined Disability Rating

At the end of this evaluation, the PEB will determine your combined disability rating.  What is this, you may ask?  It is the total amount of disability based on your injuries.  This is not simply adding up your ratings, though.  For example, if you have three ratings, 50%, another 50%, and 30%, you do not have a combined rating of 130 percent.  How does a combined rating work, then?  Look at this (and this description applies to both the DOD and the VA).

First, assume you originally had a 100% capable body. Now take your highest rating (in this case, either of the 50% ratings) and subtract it from the 100% capable body.  You now have 50% of a “good body” left.  Now take the next rating (50% again, in this case) and apply it to what is left over.  Fifty percent of a 50% capable body is 25 percent.  This leaves a 25% capable body remaining.  We now apply the lowest rating (30%) to the 25% capable body. Thirty percent of 25% is 7.5 percent.  This is subtracted from the remaining 25% and leaves us with 17.5% of a capable body left or, to put it more simply, an 82.5% disability rating.  This rating is then rounded to the nearest ten percent (in this case, 80%) and gives us our final disability rating.

If that doesn’t make sense to you at first, try rereading that last paragraph.  I will also include a visual description of this in the Resources section of this article.  It usually helps people understand the math a little better.

Transition Phase

You now have a final combined disability rating.  If that rating is less than 30% and you have less than twenty qualifying years of service (remember we’re just talking about reservists here) then you will be offered a severance package (two months of base pay times your years of equivalent active duty service (retirement points divided by 360)) and separated from service.  If you have a 30% rating or higher, you will be medically retired and begin receiving retired pay and benefits immediately.

Remember last week when I said not to be afraid of medical disqualification if you have at least fifteen qualifying years of service?  This is one of the time in which this fact becomes very important.  If you have a rating of less than 30% and have at least fifteen qualifying years, you should not accept the severance when it is offered.  You should refuse it and request transfer to the Retired Reserve.  Your branch of service will be notified of your disqualification and years of service and will then issue you an early notice of eligibility (NOE) for retired pay (which has the same effect as if you had twenty years of service and received a twenty-year letter).  Often, we call this early NOE a fifteen-year letter (even if you have sixteen or even nineteen years of service).  The fifteen-year letter will prove your eligibility for retired pay and benefits at age sixty (or earlier if you have qualifying active duty service).  If you take the severance pay (and I’ll go deeper into this topic in another article) then you lose all of the benefits you have earned.  If you have medical issues, please either get fixed or go through IDES and retire.  It’s the best thing over continuing to hurt yourself through the ardors of military service.

If you disagree with the findings of the MEB or PEB, you do have the right to appeal.  Don’t think you are without options.  There is an entire section of military lawyers who specialize in assisting soldiers going through IDES.  Use them if you think you need them.

So how long does all of this actually take?  The goal for reservists is 305 days; the goal for active duty soldiers is 295 days.  Every case is different though so this can be longer or shorter based on your circumstances.

There is one more option available to you.  If you wish to only be evaluated by the military (and not by the VA), you can choose to go through the Legacy Disability Evaluation System or LDES (pronounced El-Dez).  This can be a much shorter evaluation but it can also reduce the total benefits for which you may be eligible.  Keep that in mind as you make your decision.

I have greatly simplified things in this article (and it’s still very long).  I will go into other factors as this series progresses.

If you think this information is useful, please share it with others.  I also would be interested in your comments (good and bad) and questions.  The more I hear from you, the better I can make these articles and other content.

Thanks for joining me today and, of course, thank you for your service.

D.J.

References:

Related YouTube Episodes:
The Basics of Reserve Retirement
Help, I Need My Records. Where is My DD 214?
Should I Take Drill Pay or VA Compensation?
How to Read an Army National Guard Retirement Points Statement
How to Read an Army Reserve Points Statement
How to Read an Air Force Reserve / Air National Guard Points Statement
How to Read a Navy Reserve Points Statement
How to Read a Marine Corps Reserve Points Statement
How to Read a Coast Guard Reserve Points Statement
Final Pay vs High-3
I’m Medically Unfit for Retention. Now What?

Related Podcast Episodes:
Help, I Need My Records. Where is My DD 214?
Should I Take Drill Pay or VA Compensation?
How to Read an Army National Guard Retirement Points Statement
How to Read an Army Reserve Points Statement
How to Read an Air Force Reserve / Air National Guard Points Statement
How to Read a Navy Reserve Points Statement
How to Read a Marine Corps Reserve Points Statement
How to Read a Coast Guard Reserve Points Statement
Final Pay vs High-3
I’m Medically Unfit for Retention. Now What?

Related Articles:
Help, I Need My Records. Where is My DD 214?
Should I Take Drill Pay or VA Compensation?
How to Read an Army National Guard Retirement Points Statement
How to Read an Army Reserve Points Statement
How to Read an Air Force Reserve / Air National Guard Points Statement
How to Read a Navy Reserve Points Statement
How to Read a Marine Corps Reserve Points Statement
How to Read a Coast Guard Reserve Points Statement
I’m Medically Unfit for Retention. Now What?

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