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Presentation Introduction. Welcome to the Integrated Disability Evaluation System (IDES): An Introduction for Commanders and 1SGs of the Army National Guard. Agenda. IDES Purpose and Elements IDES Statutes IDES Phases Soldier’s Rights & Responsibilities
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Presentation Introduction Welcome to the Integrated Disability Evaluation System (IDES): An Introduction for Commanders and 1SGs of the Army National Guard
Agenda • IDES Purpose and Elements • IDES Statutes • IDES Phases • Soldier’s Rights & Responsibilities • Activities Prior to IDES and During Each Phase (including): • General Role Of The Soldier • General Role Of The Commander • MMPS • MOS Administrative Retention Review (MAR2) • Documents for MEB/PEB
Objectives Upon successful completion of this presentation you should be able to: • State the purpose of the IDES. • Define common IDES-related terms and concepts. • Describe in general each phase of the IDES process. • Access the documents that define the laws and policies that direct the IDES. • Describe the basic rights, responsibilities, and entitlements of Soldiers in the IDES process. • Identify the documents that you may need to receive from the commander and provide to the Physical Evaluation Board Liaison Officer (PEBLO) or other key individuals in the IDES. • Identify the essential information necessary in the Commander’s Statement and the difference between useful and not-quite useful information. • Describe some basic health information privacy requirements.
IDES Purpose and Elements The IDES is a joint system used by the Department of Defense and the Department of Veterans Affairs to evaluate the nature and extent of disabilities affecting members of the Armed Forces. Key Features of the IDES • Single set of disability medical examinations appropriate for fitness determination by the Military Departments • Single set of disability ratings provided by VA for appropriate use by VA and DoD. Key Elements of the IDES • Medical Evaluation Board (MEB) • Physical Evaluation Liaison Officer (PEBLO) • Physical Evaluation Board (PEB) The IDES is operated by the Secretaries of the Military Departments. ARNG-Specific Elements Connected to the IDES • Medical Management Processing System (MMPS) • ARNG Case Managers The IDES does NOT include: • Medical treatment • Professional job reclassification activities
IDES Statutes • Title 10 U.S.C. • 38 CFR, Parts 3 and 4 • DoDD 1332.18, “Separation or Retirement for Physical Disability • DoDD 6130.3, “Physical Standards for Appointment, Enlistment, Induction” • DoDI 1332.38, Physical Disability Evaluation • DoDI 6040.44, “Lead DoD Component for the Physical Disability Board of Review (PDBR)” • AR 40-400, “Patient Administration” • Directive-Type Memorandum (DTM) on Implementing Disability Related Provision of the Nation Defense Authorization Act of 2008
IDES Phases MMPS MMPS IDES REFERRAL MEB PEB Transition – Reintegration Meets Retention Standards Meets Retention Standards Transition: 45 Calendar Days Target Timeframes: 140 Calendar Days 120 Calendar Days Reintegration: 30 Calendar Days
Soldier’s Rights & Responsibilities IDES MMPS PEB REFERRAL MEB Transition – Reintegration Treatment and Case Management • Soldiers have the right to the best possible medical care for medical issues incurred in the line of duty. • The Soldier always has the responsibility to get better and heal as much as possible. • This includes • making all necessary appointments • following medical advice and guidance (the more complex the medical condition(s), the more important the requirement for compliance with treatment) • working closely with Case Managers MMPS Case Management
Soldier’s Rights & Responsibilities IDES MMPS PEB REFERRAL MEB Transition – Reintegration Review MEB Finding and Narrative Summary • Soldiers have the right and responsibility to review the MEB findings and the MEB Narrative Summary. • The PEBLO : • Answers the soldier's questions about the MEB findings and • Informs the soldier of the right to legal counseling, often referring the soldier to the judge advocate general office. • Informs the soldier of the right to legal counseling from civilian attorneys at his or her own expense.
Soldier’s Rights & Responsibilities IDES MMPS PEB REFERRAL MEB Transition – Reintegration Impartial Medical Review • Soldiers have the right to request an impartial medical review of the MEB findings and Narrative Summary. • The impartial provider cannot be a member of the MEB. The impartial provider advises the Soldier on whether the MEB findings and Narrative Summary accurately represent the member's health.
Soldier’s Rights & Responsibilities IDES MMPS PEB REFERRAL MEB Transition – Reintegration Rebut the MEB • Soldiers have the right to submit a written rebuttal disagreeing, in whole or in part, with the facts or opinions of the MEB findings or the Narrative Summary. • The rebuttal must be submitted: • To the convening medical authority • In accordance with policy • The rebuttal is reviewed by the medical authority and becomes part of the IDES case file.
Soldier’s Rights & Responsibilities IDES MMPS PEB REFERRAL MEB Transition – Reintegration Rights During the IPEB • Soldiers don't attend IPEBs. • Soldiers have the right and responsibility to review the findings of the IPEB. • Soldiers may have the right to an FPEB depending upon the outcome of the IPEB.
Soldier’s Rights & Responsibilities IDES MMPS PEB REFERRAL MEB Transition – Reintegration Rights Following the IPEB Decision • Soldiers found unfit by the IPEB have the right to an FPEB if they disagree with the findings. • Soldiers found fit by the IPEB do not have the right to an FPEB, but can request an FPEB be granted by the PEB President. • Soldiers who were previously placed on the Temporary Disability Retirement List (TFRL), then found fit by the IPEB during periodic review, have the right to an FPEB upon request. • A full and fair hearing held by the board • Personally appear before the board • Present evidence • Military legal counsel at no cost to the soldier, or civilian legal counsel at no cost to the government • Full access to the IDES case file • A copy of the written explanation of PEB findings
Soldier’s Rights & Responsibilities IDES MMPS PEB REFERRAL MEB Transition – Reintegration Submit a Written Appeal of PEB Findings • If found unfit by the FPEB, Soldiers have the right to submit a written appeal of the decision to the Army Physical Disability Appeal Board (APDAB).
Soldier’s Rights & Responsibilities IDES MMPS PEB REFERRAL MEB Transition – Reintegration Submit a Written Appeal of PEB Findings • Even after Soldiers are separated from Service, they have the right to appeal to certain boards under the Army Review Boards Agency depending upon the specifics of their appeal.
Soldier’s Rights & Responsibilities IDES MMPS PEB REFERRAL MEB Transition – Reintegration Benefits • If separated or retired from the service, a Soldier may be entitled to benefits. • Benefits directly from the Army may be a separation severance payment or a medical retirement pension. • Soldiers may also be entitled to additional benefits, such as those offered by the U.S. Department of Veterans Affairs and the U.S. Social Security Administration, and others. • It is important for the Soldier to understand that not all benefits are in the form of monetary payments.
Activities During Each Phase IDES General Role of the Commander MMPS REFERRAL General Role of the Soldier Transition – Reintegration MEB PEB Write MEB Narrative Summary FPEB Benefits Briefing Narrative Summary Review Individual Counseling PEBLO Assigned Pre-Separation Counseling IPEB Treatment Vocational Program MMPS Case Management FPEB Findings & Decision Review MEB Evaluation for Referral IPEB Findings & Decision Review Employment Workshop Case File Review and Development Transition: 45 Calendar Days Target Timeframes: 140 Calendar Days 120 Calendar Days Reintegration: 30 Calendar Days
General Role Of The Soldier • Has a duty to get better and heal as much as possible. • Provide honest input to both medical and administrative professionals throughout the process. • Attend all appointments – contact counselor if unable to make an appointment -- no shows will be reported to Soldier’s Commander. • Complete the History Form prior to physical. • Must undergo comprehensive Physical Exam • Assist the Command in providing required personnel/administrative data: • Leave and Earning Statement (LES) • Enlisted Record Brief (ERB)/Officer Record Brief (ORB) • Last 3 Non-Commissioned Officer Evaluation Reports (NCOERs)/Officer Evaluation Reports (OERs) • Army Physical Fitness Test (APFT)/HT/WT • Copies of Approved Retirement or Separation Orders • Copies of Orders for recent promotions or demotions • Concur/Non-concur with all outcomes from PEBLO counseling within the scope of rights/benefits and due process .
General Role Of The Commander • Refer a Soldier for medical evaluation when the Soldier is believed to be unable to perform the duties of his or her office, grade, rank, or rating • Prepare the Commander’s Assessment (DA Form 7652) of the Soldier’s ability to perform their current job within 5 calendar days of the requested date (or the next reserve drill date). • Ensure that any physical defects impacting on a Soldier’s performance of duty are reflected in the Soldier’s evaluation reports. • Provide a complete Line of Duty (LOD) investigation and determination (DA 2173) within 5 days of the request date (or the next reserve drill date). • Provide the information, statements, and records on Soldier’s of their command being processed for physical disability evaluation • Ensure timely compliance with all requirements to prevent delays in the disability processing. • The Commander (or designee) must attend the Orientation Briefing with the PEBLO.
General Role Of The Commander (Cont) • Maintain accountability and visibility of the Soldier through the process. • Ensure changes in Soldier’s duty status are immediately reported to the MEB Office. • Inform the PEBLO of any scheduling conflicts with IDES appointments and that Soldier’s absences are coordinated with PEBLO • Ensure Soldiers attend all IDES-related appointments and VA medical examination appointments. • Commanders may discuss the contents of the non-medical assessment with the Soldier before submission to the PEB. • Ensure IDES referred Soldiers are assigned military duties that are appropriate to their condition or recovery care plan. • Commanders must manage the Soldier’s authorized leave to ensure that it does not interfere with the processing of the MEB. They should encourage Soldiers to use accrued leave during the PEB Phase, i.e. after the MEB Phase and before the Transition Phase.
MMPS MMPS The Medical Management Processing System (MMPS) is a process which provides for case management of Soldiers with illnesses or injuries with a prognosis for recovery that is greater than thirty days. • Monitors, manages, and facilitates medical care for medically non-available Soldiers. • Ensure timely effective and efficient of care through the medical system • Follows cases to a state of maximum recovery called the Medical Readiness Decision Point (MRDP) • Transfer documentation to the Health Readiness Record (HRR)
MMPS – Key Personnel MMPS • Battalion Medical Readiness Non-Commissioned Officer (BN MRNCO) report to Battalion Commander • Health Systems Specialist (HSS) report to the State G1 (most states) • Case Managers (CM) report to the Deputy State Surgeon (DSS) • Care Coordinators (CC) work for Case Managers and report to DSS. • Military Health Care Providers report to the State Surgeon • Deputy State Surgeon report to the State Surgeon
MOS Administrative Retention Review (MAR2) If a physician determines that a Soldier has a medical condition that require a permanent profile (3 or 4) but may still meet retention standards, the Soldier undergoes a MOS Administrative Retention Review (MAR2). Not an actual part of MMPS or IDES, but could potentially feed into IDES. • Possible outcomes: • Retain Soldier in his/her Primary MOS • Reclassify Soldier to another Primary MOS • Refer to IDES • Advantages of MAR2: • Smaller board • Quicker decision for Soldiers who do meet retention standards • Allows ARNG to retain Soldier by reclassification
Treatment IDES MMPS PEB REFERRAL MEB Transition – Reintegration The treating medical provider forwards the case to an IDES-trained medical provider for review when the medical condition: • Makes it unlikely that the Soldier will return to duty within one year of the diagnosis • If the diagnosis automatically requires a referral into the IDES according to policy
Evaluation for Referral IDES MMPS PEB REFERRAL MEB Transition – Reintegration The IDES-trained medical provider reviews the Soldier's case file to determine if referral is appropriate. If the IDES-trained provider determines: • return to duty within a year is questionable • medical condition requires referral by policy the case is referred into the IDES for evaluation by a Medical Evaluation Board The IDES-trained providers can be valuable resources to the treating medical provider by recommending appropriate modifications to duty restrictions.
PEBLO is Assigned IDES MMPS PEB REFERRAL MEB Transition – Reintegration A PEBLO is assigned to each IDES case. The PEBLO • Conducts an initial briefing • Describes the IDES process • Answers Soldier’s questions • Works with the MEB to gather any information • Schedules appointments required to complete the disability evaluation.
Case File Review & Development IDES MMPS PEB REFERRAL MEB Transition – Reintegration A medical provider begins writing a review of the Soldier’s medical case and its occupational impact. Service regulations specify the information required to establish the functional impact of a medical condition. When a case file is not complete, the IDES-trained provider works with the PEBLO to gather required information, including: • VA Compensation and Pension (C&P) Exam worksheet, • Medical test results, • Consultation reports • Commander's input.
MEB Narrative Summary IDES MMPS PEB REFERRAL MEB Transition – Reintegration Once the physical exam is complete and all the medical and occupational documentation is compiled: • MEB Narrative Summary is written • Case file is forwarded to the MEB members for review.
MEB IDES MMPS PEB REFERRAL MEB Transition – Reintegration • The MEB : • Ensures the full clinical and occupational impact of all medical conditions is accurately represented • Documents which conditions are cause for referral to the PEB and makes disposition • Makes disposition • If none warrant referral, the member is transitioned back to duty.
Narrative Summary Review IDES MMPS PEB REFERRAL MEB Transition – Reintegration • After the MEB members sign the board, the PEBLO : • reviews the findings with the Soldier • advises the Soldier of the process • advises Solider of • the right to request an impartial medical review and • the right to rebut the findings to convening medical authority • If the case is not referred to a PEB, the Soldier is transitioned back to duty.
Informal PEB (IPEB) IDES MMPS PEB REFERRAL MEB Transition – Reintegration • The PEB always begins with the Informal Physical Evaluation Board. • Board members usually don't meet in person. • Soldiers don't appear before the IPEB. • Each member reviews the complete case file. • Each member renders independent findings that are then consolidated for a single finding by the board.
Informal PEB (IPEB) IDES MMPS PEB REFERRAL MEB Transition – Reintegration • IPEB Decision: • Renders a fit or unfit finding • Provides a rating for all unfitting conditions • The rating is used to calculate the value of the Soldier's compensation • Determines if the disability meets the criteria for compensation • Determines if the condition existed prior to service • Determines if the disability is medically stable or expected to change over an extended period of time • A Soldier with a disability that is expected to change may be placed on the TDRL
IPEB Decision & Findings Review IDES MMPS PEB REFERRAL MEB Transition – Reintegration • The PEBLO reviews the IPEB’s findings with the Soldier. • PEBLO advises that: • Soldier found unfit has the right to a Formal PEB (FPEB) • Soldier found fit may submit a written request for and FPEB to the PEB President • PEBLO answers any question about: • The IPEB’s findings • Benefits and entitlements they are likely to receive • PEBLO also advises that: • The FPEB is independent of the IPEB • FPEB findings could lead to a higher or lower disability rating (a raise or reduction in benefits)
FPEB IDES MMPS PEB REFERRAL MEB Transition – Reintegration • FBEP is: • Convened at the Soldier’s request • Open board whereby the Soldier may appear in person with legal counsel • Soldier is entitled to: • Present evidence • Make a statement • Remain silent • The FPEB considers all evidence, independent of the IPEB, before making a fitness determination. • The determinations made by the FPEB are the same as for the IPEB. • The decisions by the FPEB will supersede those of the IPEB.
Review FPEB Findings IDES MMPS PEB REFERRAL MEB Transition – Reintegration • The PEBLO: • Reviews the findings of the IPEB with the Soldier • Refers Soldier found unfit to the Transition Assistance Program • Refers Soldier found unfit to a medical Care Coordinator to ensure uninterrupted medical care • PEBLO answers any question about: • The FPEB’s findings • Benefits and entitlements they are likely to receive • PEBLO also advises that: • The right to submit a written appeal to the Army Physical Disability Appeal Board (APDAB) prior to separation • The right to submit an appeal after separation to one of the following boards as appropriate: • Army Board for Correction of Military Records • Army Physical Disability Review Board • Army Disability Rating Review Board
Pre-Separation Counseling IDES MMPS PEB REFERRAL MEB Transition – Reintegration • The Soldier who is transitioning to civilian life is referred to the local transition office or transition counselor. Reviews the findings of the IPEB with the Soldier • Pre-Separation counseling includes information on: • Education • Training • Employment Assistance • Medical Benefits • Financial Assistance • Public and Community Service
Employment Workshop IDES MMPS PEB REFERRAL MEB Transition – Reintegration • The Department of Labor sponsors employment assistance workshops that provide information regarding: • Resume writing • Interviewing techniques • Job search skills • Job placement • Job fairs • Job training • Individual skill assessments • On-line job banks
Benefits Briefing IDES MMPS PEB REFERRAL MEB Transition – Reintegration • The Veterans Benefit Administration conducts VA briefings in which the following topics are reviewed: • Education and training • Health care • Home loans • Life insurance • Burial benefits • Dependents' and Survivors' benefits • state VA
Vocational Program IDES MMPS PEB REFERRAL MEB Transition – Reintegration • For Veterans enrolled in the Vocational Rehabilitation and Employment Program, the VA pays for : • Tuition • Books • Fees • Necessary supplies • Other training benefits may include college, apprenticeships, or on-the-job training.
Individual Counseling IDES MMPS PEB REFERRAL MEB Transition – Reintegration • After completing the four components of the Transition Assistance Program, the Soldier may need additional assistance. • VA counselors and other qualified subject matter experts provide one-on-one counseling and coaching based on the Soldier’s needs.
Documents for MEB/PEB The PEBLO assigned to your Soldier's case will notify the Commander of the documents that should be provided for the IDES. Documentation may include: • Commander’s letter • Line of Duty investigations and determinations • Physical performance records • Personnel evaluations. Ensure that all signatures are current and send the documents to the PEBLO, as soon as possible!
Essential Data in the Commander’s Statement When a Soldier is referred for physical disability evaluation the commander provides critical evidence of the member’s actual duty performance and assist the provider in assessing the impact of the clinical condition. The Commander’s Statement should be a concise, succinct statement to describe: • Job tasks required of the Soldier’s Primary MOS • The impact that the Soldier’s medical condition has on his/her ability to perform military duties and the reality of the member’s contribution. • The Soldier’s ability to maintain physical fitness • The Soldier’s availability for work (e.g., days off due to illness, injury or treatment) • The Soldier’s attitude towards the job, including work relationships with supervisors and co-workers • The Soldier’s ability to deploy, carry a rucksack, and handle a weapon
Writing the Commander’s Statement – Blank Form DA Form 7652, Commander’s Performance and Functional Statement When completing this form, commanders should avoid the use of “N/A” or “Not observed” in your responses. These statements provide no benefit for the board members adjudicating the case and the commander will likely be contacted for some form of information.
Writing the Commander’s Statement Provides minimal information on impact of the medical condition on military duties, but not enough detail about job tasks.
Writing the Commander’s Statement Includes details about the specific tasks required in this Soldier’s occupational specialty that have been impacted by his psychiatric condition.
Summary • IDES Purpose and Elements • IDES Statutes • IDES Phases • Soldier’s Rights & Responsibilities • Activities Prior to IDES and During Each Phase (including): • General Role Of The Soldier • General Role Of The Commander • MMPS • MOS Administrative Retention Review (MAR2) • Documents for MEB/PEB