What Service Members Need to Know About the Integrated Disability Evaluation System (IDES)
Nearly every veteran knows someone who has had to leave the service due to a medical condition. Many injured or wounded service members whose conditions result from their military service are medically retired from service. Each of these veterans must go through the Integrated Disability Evaluation System prior to receiving benefits after discharge.
If you develop a medical issue that prevents you from performing your military duties, you will eventually be referred to the Integrated Disability Evaluation System, or IDES. The IDES system consists of a number of health care and administrative processes that will determine the extent of your disability and the future of your military career. If the disability is severe enough, you will eventually be discharged from the military, and potentially receive medical retirement benefits.
Role of the Integrated Disability Evaluation System
The IDES bridges the gap between the Department of Defense and the Department of Veterans Affairs. It merges the two organizations’ disability procedures. IDES combines the DoD and VAs fitness for duty requirements into a single set of medical exams and disability ratings.
IDES officials then use these disability ratings to arrive at your VA disability rating.
IDES has been successful in streamlining and improving the reliability and timeliness of VA disability rating rulings. All military departments within the DoD have adopted IDES as their disability review standard.
History of IDES
The DoD developed the Integrated Disability Evaluation System in 2009 to merge the DoD and VA disability evaluation processes. The objective was to streamline and improve the entire disability assessment and disposition process across the entire Department of Defense and Veterans Administration.
IDES represents a significant improvement over legacy systems because it allows the DoD and VA to efficiently share information between their two systems, and work together to provide service members and veterans with a speedy and accurate disposition.
Not every wounded or injured service member will go through IDES. The Integrated Disability Evaluation System only comes into play if the service member has one or more medical issues that render them unable to perform their duties. If approved, these service members are candidates for DoD disability compensation.
If you denied DoD disability compensation via IDES, you may still qualify for disability compensation through the VA. In that case, you must go through the VA disability process, which is separate from IDES.
Elements of Integrated Disability Evaluation System
The Integrated Disability Evaluation System process consists of four stages:
- Medical Evaluation Board (MEB)
- Physical Evaluation Board
- Service Member Counseling
- Final Disposition
When Do You Enter the Integrated Disability Evaluation System?
If your doctor reaches a finding that you are probably not going to be able to return to duty within 12 months of the onset of your injury, illness, wound, or condition, he or she will refer you into the IDES.
At that point, IDES officials will assign you a physical evaluation board liaison officer (PEBLO), who acts as a case manager on the DoD side. The PEBLO’s role is to educate you on the process and the events that will occur. They will also counsel you on your own responsibilities within the IDES process, and answer any questions you may have.
The PEBLO will also request and gather any available medical records that may be needed to document your condition. Once the PEBLO obtains these records, you will be assigned to your Military Service Coordinator (MSC). This individual’s role is to manage your case on the VA side.
While the PEBLO’s focus will be on the specific medical condition or conditions that resulted in your referral to IDES, the VA’s MSC will be working with you to identify all medical conditions that may be relevant to a future VA claim. In many cases, service members have multiple medical conditions, even if only one of them is specifically resulting in an inability to return to full duty status with 12 months of onset.
Your MSC’s role is also to help you schedule any necessary VA medical examinations for your claimed or referred medical conditions.
The Role of the Medical Evaluation Board
Once your VA medical examinations are complete, the case goes back to your PEBLO, who will set up a medical examination board (MEB) at a nearby Military Treatment Facility. The MEB represents the medical stage of the IDES process. The Board must consist of at least two medical doctors. If your case involves a mental health or psychological condition, the Board must also include at least one mental health professional.
The MEB will look at your records and document your medical status and any duty limitations. These include any medical condition that is expected to prohibit you form reasonably performing military duties consistent with your rank, rating, office, or duty position. The MEB will assess your medical status in accordance with service-specific medical retention standards.
Note that the MEB will assess whether you meet the medical standards for retention within the service. They do not evaluate your level of disability, nor do they assess your fitness for duty.
What’s in your MEB case file?
Your MEB file is the file of documents that your Medical Evaluation Board members will review to determine whether you medically meet your branch of service’s standards for retention.
It will include:
- A NARSUM, or narrative summary of your medical condition and case history;
- Military and civilian medical treatment records;
- Medical examination findings;
- Letters from your chain of command, explaining how your medical condition affects your ability to perform your assigned duties;
- Any other available information the MEB may require.
Integrated Disability Evaluation System (IDES) MEB Decisions
The MEB’s entire role is to decide whether you meet the service-specific standard for retention in the military. If they determine that you are fit for duty, you’ll be returned to full duty status in your current unit.
If you do not meet the medical standards for retention, the next step is to refer your case to the Physical Evaluation Board for further consideration.
Appealing MEB Decisions
You may request that an impartial physician review your NARSUM and other records. If you believe the MEB decided wrongly, you are also entitled to present a rebuttal to their findings.
Service members may request that an impartial physician review the medical evidence presented in the NARSUM. You can also submit a rebuttal to your the MEB’s findings, if warranted.
Role of the Physical Evaluation Board (PEB)
Once your case clears the MEB and goes to the Physical Evaluation Board, the medical portion of IDES is concluded. You may still have medical issues to resolve with the VA, but that will not be a part of IDES and will generally occur post-discharge.
The PEB’s role is to assess whether you are fit for continued military service. If you can’t continue within the military, the PEB will evaluate your disability level based on any duty-related injuries or impairments. This is critical to deciding your eligibility for DoD disability benefits.
The PEB will attempt to assess how your medical condition will affect your capacity to do your job within your MOS or rate.
There are two kinds of PEBs – informal PEBs and formal PEBs.
The Informal PEB, or IPEB, is the first level of review after the Medical Review Board reaches its finding.
The IPEB will consist of at least two officers, who will look at a variety of factors, including:
- Letters from your chain of command
- Your MOS or rate
- Your specific impairments or disabilities
- Service treatment records
- Your NARSUM
- Any other available information they may require.
The IPEB’s Decision
The IPEB may determine that your documented medical conditions or physical disability do not prevent you from performing your military duties. If this is the case, you’ll be returned to full duty status.
If the IPEB finds that you are no longer able to continue performing your duties consistent with your rank, office, MOS or rate, they must then determine whether your condition was caused by or aggravated by your military service.
The disability does not have to be combat-related.
If your condition debilitating but is not service-related, you may be discharged, but not eligible for DoD or VA disability compensation.
However, if the IPEB determines that your medical condition is caused or aggravated due to your military service, and that your condition is severe enough to render you unable to perform your military duties, they will refer your case to the VA Disability Rating Activity Site (DRAS) for further assessment.
Your IPEB Disposition: Separation vs. Medical Retirement
The DRAS will look at your medical documentation and come up with a proposed disability rating. If you have multiple medical condition, the DRAS will propose a disability rating for each condition. The IPEB uses this rating decision information to decide whether you will be simply separated from service, or whether you will be medically retired.
If your disability rating from the VA’s DRAS is 20% or less, you’ll be separated from the service, but not medically retired. You will be entitled to severance pay, but not DoD medical retirement pay. You may pursue a claim for VA disability compensation, which is separate from DoD medical retirement compensation.
If the DRAS proposes a disability rating of 30% or greater, you may be entitled to retirement pay and benefits. If your condition is not stable, you will be placed on the Temporary Disability Retired List (TDRL) for up to three years, during which time you will be entitled to retirement pay and benefits.
While you are on the TDRL, you will have to present yourself for periodic medical examinations to be eligible for continued pay.
If your condition improves sufficiently during this time, you may be returned to duty.
Appealing the IPEB Determination
If your IPEB finds you unfit for retention, you can appeal the IPEB, and request reconsideration from a Formal Personal Evaluation Board (FPEB). The FPEB consists of at least three officers: The president, a field-grade personnel officer, and a senior medical officer.
You may appear before the FBEB in person, and can discuss your case with them. This may allow you to provide additional information, and more effectively make your case why you should be retained in service.
If you choose, you can also have a JAG officer or other legal counsel represent you before the Board. Additionally, you may call witnesses on your behalf.
After the FPEB has reviewed all the documents and heard all relevant testimony from you and any other witnesses, they will reach a disposition ruling:
- Return to duty;
- Separation with benefits;
- Separation without benefits;
- Medical retirement.
Appealing the FPEB
If you still disagree with the FPEB’s ruling, you can appeal to the appellate review authority within your military department.
You may also request to continue your active duty or reserve component military service. Specific procedures and requirements vary by service.