This is a general, 1,000 foot overview of the military’s DES. There are many nuances and service specific regulations that must be considered, but the below overview should be helpful in explaining the general process to service members and representatives.
How and why is someone referred into the DES?
Generally, referral into the DES starts with a service member’s commanding officer or a medical professional at a military treatment facility (MTF) referring the service member to a Medical Evaluation Board (MEB). This occurs when a service member is believed to be unable to perform the duties of their office, grade, rank, or rating. Further, use of certain medications or diagnosis of specific medical conditions automatically requires referral to a MEB. Department of Defense Instructions and service specific regulations mandate when a service member will be referred.
What is an MEB?
A MEB is a group of at least two physicians at the local MTF who review a service member’s medical situation. Generally, after developing the service member’s medical history, the MEB will make one of three findings: (1) return the service member to full duty, (2) place the service member on a period of Limited Duty/Profile, or (3) forward the service member’s case to the Physical Evaluation Board (PEB).
Medical Evaluation Board documentation
The MEB record will include a summary of the service member’s medical condition(s), limitations, and expected return to duty date (when applicable). The MEB will develop a detailed clinical report, narrative summary, and include a commander’s nonmedical assessment.
Referral to the Physical Evaluation Board
When the MEB makes a medical determination that an inured or sick service member may not return to full duty or when directed to by the service secretary, a completed MEB is referred to the PEB to determine the service member’s fitness to remain on active duty. The PEB will make one of three findings: (1) find the service member fit and return to full duty; (2) find the service member unfit and either medically retire or medically discharge the service member; or (3) authorize permanent limited duty.
Informal Physical Evaluation Board (IPEB)
The IPEB is the first level of review at the PEB. The PEB, comprised of senior military officers and physicians, reviews the MEB and makes a determination regarding the service member’s fitness. The service member will be notified of the IPEB’s findings. After reviewing the findings, the service member may accept the IPEB’s disposition, appeal the disposition as a matter of right to the Formal Physical Evaluation Board (FPEB), when applicable)), or request an appeal to the FPEB.
Formal Physical Evaluation Board (FPEB)
The FPEB is the second level of review at the PEB. When a FPEB is granted, the service member may appear in person with representation. The service member will be notified of the FPEB’s disposition, and can either accept the findings or file a petition for relief (PFR).
Petition for Relief
Following a FPEB, when the findings of the PEB become final, and the service member has exhausted all of the available options with the PEB, service members who have not yet been discharge or separated, and temporary disability retirement list (TDRL) personnel, may PFR. The PFR disposition must be rendered while the service member is still in service or on TDRL. If the PFR is unfavorable to the service member, he may appeal, but most likely has no avenue of appeal until after separating from the military. That appeal will likely be to the service’s Board for Correction of Military Records (BCMR).
Throughout the DES, there are many people involved and mandatory steps for proper adjudication of a service member’s case. Many forms of “appeal” or reconsideration are available during the process, including rebuttals to the MEB or narrative summary, impartial medical reviews (IMR), and Veterans Administration Rating Reconsiderations (VARR). A service member should be in constant communication with competent representation throughout each stage of the process to afford them the best possible outcome. These representatives should know the availability of specific procedures that could significantly help a service member achieve what they desire. Representatives should take time to perform a cost benefit analysis of each option and explain them to the service member.