IDES Toolkit​ ​

MEB Phase
What happens after the referral?
The wounded, ill, or injured Service Member will be assigned a PEBLO, located in the Medical Boards section of the military treatment facility (MTF), who will develop the VA Claim (Part 1 of the VA Claim Form 21-0819).  PEBLOs will consult with all medical specialists to determine which medical condition(s) should be included.  The Service Member will be referred to a VA claims development representative, the Military Service Coordinator (MSC) who counsels them on the VA portion of IDES and assists them in completing parts II-IV of the claim.  Additionally, the MSC will schedule all VA medical exams required for the IDES process.  In addition to the MEB referred conditions the Service Member may claim disability for any service incurred or aggravated medical conditions.

Physical examination, specialty examination, diagnostic testing, laboratory test
Examinations (including laboratory and diagnostic tests) are completed by a combination of military, VA, or authorized civilian medical providers.  Results are summarized in the Narrative Summary (NARSUM).  The DoD MTF is responsible for the production of the NARSUM and Medical Evaluation Board Report (also referred to as the IDES case file).  The PEBLO oversees the final assembly of all components of the case filed and delivers to the local MTF convened Medical Evaluation Board (MEB).

Documents Contained in IDES cased file

Typical Medical Evidence

• A narrative summary (NARSUM)
• History and treatment of the specific injury or illness
• Laboratory results
• All referrals to doctors and sick call (health record)
• Type and frequency of medication
• Results of physical exam completed within past six months
  

Typical Non-Medical Evidence:

• Non-medical Assessment from the member's unit commander (impact of medical condition(s) on normal military duties)
• Line of duty (misconduct) investigations
• Personnel Casualty Report (PCR) as applicable
• Last two years of fitness reports or pros and cons
• Member's Personal Impact Statement

Medical Evaluation Board Determination
The MEB consists of two to three medical officers appointed by the local MTF Commander.  They review the IDES case file to determine appropriate diagnosis and ability to return to full, unrestricted duty.  If the Service Member is expected to recover and return to full duty, the MEB may recommend placing them on Temporary Limited Duty (TLD) for a specific time frame, after which the Service Member must return to full duty.  Otherwise, the Service Member will be referred to the Physical Evaluation Board (PEB) phase.

PEB Phase
Informal Physical Evaluation Board
The PEB Informal Physical Evaluation Board (IPEB) reviews all the evidence contained in the IDES case file, to include the Service Member's entire medical record to make a fitness determination and record their finding on the following:

• Determine if the medical condition(s) was incurred in the line of duty
• Determine if Service Member is Fit or Unfit for continued service
• Recommend return to duty if found Fit; or if found Unfit
• Identify the specific military unfitting medical condition(s)
• Recommend separation from active duty with final disposition based on the degree of disability (percentage awarded by VA) for the military unfitting medical conditions
• Determine if the military unfitting conditions were incurred as the result of a combat related event, and/or in a combat zone
• Forward the case to the VA Disability Rating Activity Site (D-RAS) to determine degree of disability for each condition claimed

Veterans Administration Disability Rating Activity Site
The VA Disability Rating Activity Site (D-RAS) thoroughly evaluates the Service Member's referred and claimed conditions to produce a rating letter that explains the disability rating applied.  Each condition is rated from zero to 100% and results are submitted to IPEB.  The IPEB and D-RAS findings are merged and submitted to the PEBLO for delivery to the WII Service Member.

If the Service Member is found Unfit, they have three options:

• Accept the findings of the IPEB and the VA rating decision
• Accept the findings of the IPEB and request a one time reconsideration of the VA rating decision; or
• Disagree with the findings and request or demand a Formal Physical Evaluation Board

Formal Physical Evaluation Board
All Service Members found Unfit by the IPEB have the right to a formal hearing.  Upon approval and scheduling, the respective service will assign a Judge Advocate attorney to the Service Member.  The Service Member may choose a non-military attorney, but they will be responsible for any costs.  The attorney will prepare the petition, gather evidence and present their case to the Formal Physical Evaluation Board (FPEB).  Once the case has been presented, the board deliberates and prepares a findings letter with written rationale.  Any previous IPEB findings are null and void.  The findings and rationale are reviewed by the Department of the respective service PEB President before being released to the Service Member.  These findings become the decision of record.

Why would a Service Member request FPEB review?
Generally Service Members request the FPEB for two reasons:
1. To challenge their Fitness determination.
2. To add other medical conditions to the list of military unfitting conditions (which may result in a higher combined disability rating that could qualify the Service Member for disability retirement vice a disability separation).

​Transition Phase
Transition begins after the Service Member accepts the PEB findings or completes formal and military appeals.  At this point, the VA is informed of the final disposition, receives a copy of the separation orders and DD Form 214, and conducts a final interview with the Service Member, their dependents, or other representatives to determine entitlement to benefits; gather supporting documentary evidence, and file claims on behalf of the Service Member for benefits allowable under state and federal law.