Disability Evaluation System (DES) Overview NGB/SGPA

Objectives DES Retention Standards When to start processing Duty related DES Non Duty related DES Retention Standards When to start processing

DES Purpose of DES: to maintain a fit and vital force There are two types of Disability Evaluation Systems (DES). Integrated Disability Evaluation System (IDES) - duty related Two step process- Pre-IDES and IDES Non-Duty DES System (NDDES) – non duty related Type of DES processing is contingent on whether the injury, illness or disease incurred or was aggravated due to military service or not. In other words- is the condition “In the Line of Duty (ILOD) or not”?

Duty Related DES Pre- IDES Purpose: eliminate amount of referrals to Medical Evaluation Board (MEB) for members who can be returned to duty with (or without) an Assignment Limitation Code (ALC). MEB cannot happen without being referred from NGB/SGPA. MEB is a term that is overused and should only be used when member is actually referred for the MEB process. Terms IRILO or pre-IDES should be used to distinguish the various processes Initial Review in Lieu of (IRILO) Name of package submitted to NGB/SGPA for review and disposition Includes LOD, Narrative Summary (NARSUM), etc. Not every IRILO will lead to an full MEB Afi 41-210 para 4.51.1.2-

Duty Related DES IDES Once MEB is directed by NGB/SGPA, member is entered into IDES as of date on VA Form 21-0819 Joint Disability Evaluation Board Claim form. ANG MDGs do not initiate the VA Form 21-0819 MEB phase of IDES begins Can take up to 305 calendar days to complete IDES

Non Duty Related DES Purpose: review potentially disqualifying medical conditions for a “Fitness for Duty” evaluation Conditions that are “Not in Line of Duty”

Retention Standards Medical Standards Directory (MSD) Unable to meet retention standards and/or mobility standards Not all inclusive IAW AFI 48-123 para 5.3.2 DES will begin within 90 days of diagnosis: Examples include: seizures, any terminal illness, organ failure requiring transplant, insulin dependent diabetes, or any other career ending injury

When to start DES Within 1 year of diagnosis that prevents full duties OR When the course of recovery is relatively predictable OR When medical condition that represents an obvious medical risk to health of member or safety of others May be initiated anytime member is not anticipated to regain mobility or retention eligibility within 12 months of the initial DLC There is NO maximum medical benefit

When to start DES AFI 41-210 para 4.52.2.1…. There is no minimum medical evaluation time period and no need to wait for complete or near-complete recovery. There should be no delay in referral of a member‘s case as long as the course of recovery is relatively predictable, and a reasonable determination can be made that the limiting condition is not likely to resolve or improve within 12 months to an extent which renders the SM capable of fully performing the duties of his/her office, grade, rank or rating, to include the ability to deploy to field conditions.

YES NO DES Flow Chart IDES begins Is the condition In the Line of Duty (ILOD)? YES NO Non Duty DES (NDDES) Pre-IDES /IRILO NGB review/ disposition NGB review/ disposition IDES begins RTD with or without ALC code Referred for Medical Evaluation Board (MEB) Referred to Informal Physical Evaluation Board (IPEB) RTD with or without ALC code