The joint U.S. Department of Defense (DoD)-Department of Veterans Affairs (VA) Integrated Disability Evaluation System is the process by which DoD determines fitness for duty and separation or retirement of service members because of disability. Service members who are evaluated for disability undergo a comprehensive medical examination to document all medical conditions and receive a disability rating for every condition documented during the exam. DoD and the VA use these ratings to determine the amount of disability compensation service members receive if they are determined to be unfit to continue serving and consequently medically discharged. Proposals for reforming the DoD compensation system have been considered in the past, but a rigorous evaluation of what those alternatives might look like and how they would affect service member benefits and costs to DoD has not been conducted. In this report, the authors describe their evaluation of four hypothetical alternative disability compensation approaches that would support a simpler disability evaluation process: compensating based on the current objectives of the DoD system (and using current benefit formulas), compensating on the basis of a military career, compensating on the basis of unfitting conditions, or compensating similar to U.S. allies. Each alternative reduces reliance on disability ratings for determining DoD disability compensation and focuses primarily on a single decision about whether a service member is fit to perform his or her duties. The authors evaluate the potential effects of each alternative on service member compensation, processing times, end strength, lost skills and experience, and readiness.

In 2007, the Department of Veterans Affairs (VA) and Department of Defense (DoD) received presidential direction to conduct a joint program to modernize and improve the disability evaluation and compensation process for wounded, ill, and injured Soldiers. VA and DoD collaborated to develop the Integrated Disability Evaluation System(IDES).The goals of IDES are to:• Reduce the overall time it takes a Soldier to progress through the IDES process, starting at the time of referral to the Medical Evaluation Board (MEB) and ending upon receipt of VA benefits or return to duty (RTD);• Utilize a single examination process that meets the needs of VA and DoD; and• Increase transparency of both the military disability evaluation system and VA claims processes for wounded, ill, and injured Soldiers and their families.The IDES process identifies all medical and/or psychological conditions that impact military occupational function for the purposes of determining fitness for duty and entitlement to military and/ or VA disability compensation. The core IDES process is standardized to ensure that each Soldier, Command, and the Army Staff understand their critical contributions to case processing. Accountability measures based on the minimum necessary standards are in place at all levels across the Army. This guidebook clarifies the processes, roles and responsibilities, and standards measured at each IDES step.The IDES Guidebook is intended solely to provide MTFs and their personnel with a description of IDES practices and procedures. The IDES Guidebook should not be construed or referenced as an authoritative source for IDES regulations or policy. In-text citations refer to authoritative IDES policy and regulations. Readers should always seek out these authoritative sources when necessary and should not, in any case, cite to the IDES Guidebook as Department of the Army policy.

The Disability Evaluation System (DES) is a management tool used by the Department of Defense to determine the disposition of a service member who has a medical condition that calls into question the member's ability to perform his or her duties. The DES exists to evaluate service members with such medical conditions, remove those unable to fulfill their duties, and determine a disability rating for those who are removed. This book focuses on four major research tasks related to improving system performance: developing a basis for assessing DES outcomes, identifying issues of variability in DES policy application, conducting a DES training analysis and presenting recommended changes, and developing a method for continuously monitoring DES performance. As part of their findings, the authors constructed a set of desired system outcomes and from that framework suggest comprehensive training and information management interventions to improve overall system performance. The authors also identify groups of primary DES participants and outline the specific bodies of knowledge and skills the participants require to execute disability policy consistently throughout the military departments.

The United States Social Security Administration (SSA) administers two disability programs: Social Security Disability Insurance (SSDI), for disabled individuals, and their dependent family members, who have worked and contributed to the Social Security trust funds, and Supplemental Security Income (SSSI), which is a means-tested program based on income and financial assets for adults aged 65 years or older and disabled adults and children. Both programs require that claimants have a disability and meet specific medical criteria in order to qualify for benefits. SSA establishes the presence of a medically-determined impairment in individuals with mental disorders other than intellectual disability through the use of standard diagnostic criteria, which include symptoms and signs. These impairments are established largely on reports of signs and symptoms of impairment and functional limitation. Psychological Testing in the Service of Disability Determination considers the use of psychological tests in evaluating disability claims submitted to the SSA. This report critically reviews selected psychological tests, including symptom validity tests, that could contribute to SSA disability determinations. The report discusses the possible uses of such tests and their contribution to disability determinations. Psychological Testing in the Service of Disability Determination discusses testing norms, qualifications for administration of tests, administration of tests, and reporting results. The recommendations of this report will help SSA improve the consistency and accuracy of disability determination in certain cases.

In Feb. 2007, a series of Wash. Post articles disclosed deficiencies in the provision of outpatient services at Walter Reed Army Med. Center, raising concerns about the care for returning servicemembers. These deficiencies included a confusing disability evaluation system and servicemembers in outpatient status for years without a clear understanding about their plan of care. In response, the Army took a number of actions and DoD formed a joint DoD-VA Senior Oversight Comm. This statement provides info. on the near-term actions being taken by the Army and the broader efforts of the Senior Oversight Comm. to address longer-term systemic problems that impact health care and disability evaluations for returning servicemembers. Illustrations.

In Feb. 2007, a series of articles in ¿The Washington Post¿ about conditions at Walter Reed Army Medical Center highlighted problems in the military¿s disability evaluation system (DES). Subsequently, the Dept. of the Army, the DoD, and the VA undertook initiatives to address concerns with the DES. In 2007, the Army took steps to streamline its process, and DoD and VA began piloting a joint evaluation system to address systemic concerns abut timeliness and the potential inefficiency of having separate DES. This report examines: (1) recent actions by the Army to help servicemembers navigate its DES; and (2) the status, plans, and challenges of DoD and VA¿s efforts to pilot and implement a joint DES Includes recommendations. Illustrations.