e. ... The following medical conditions must be reviewed carefully by the clinician before making a recommendation as to whether the Soldier can deploy to duty in a combat zone (or austere isolated area where medical treatment may not be readily available).
(1) Diabetes requiring insulin. ...
(2) Diabetes requiring oral medication for control. ...
(3) Cardiovascular conditions...the Soldier should not be deployed with any of the following conditions-
(a) Hypertension not controlled with medication.
(b) Recent episodes necessitating emergency room visits or closely monitored follow-up care.
(c) Permanent pacemakers, implanted antitachycardia and automatic implantable cardiac defibrillator (AICD) devices, ...
(d) Conditions requiring anticoagulants.
(e) Bare metal coronary stents. ...
(f) Drug eluting coronary stents. ...
(g) Closure device for patent foramen ovale or atrial septal defect. ...
(h) Cardiac arrhythmias. ...
(i) Smallpox vaccine associated myocarditis. ...
(4) Neurological conditions. Review paragraph 3-30 for profile guidance and MEB/PEB processing criteria.
(a) Seizure disorders. ...
(b) Demyelinating conditions.
(6) Sleep apnea.
(a) A psychiatric condition controlled by medication should not automatically lead to nondeployment. Soldiers with a controlled psychiatric illness can still deploy. ...
(b) Medications that may be used safely in theater include selective serotonin re-uptake inhibitors and sleep medications. In general, anti-manic and anti-psychotic medications should not be used in theater because of their sideeffects.
(9) History of heat injuries.
(10) Pregnancy. Pregnant Soldiers will not deploy.
(11) History of cancer. ...
(12) Chronic infectious diseases (HIV, Hepatitis B or C) ...
(13) Abnormal Cervical Cytology. ...
(14) Malignant hyperthermia. ...
(15) Contact lenses. ...
(16) Miscellaneous conditions. ...
(17) Medications. Soldiers taking medications should not automatically be disqualified for any duty assignment. Medications used for serious and/or complex medical conditions are not usually suitable for extended deployments. The medications on the list below ...
(18) Dental. ...
7-4. Temporary vs. permanent profiles
b. Temporary profiles. A temporary profile is given if the condition is considered temporary, the correction or treatment of the condition is medically advisable, and correction usually will result in a higher physical capacity. Soldiers on active duty and RC Soldiers not on active duty with a temporary profile will be medically evaluated at least once every 3 months at which time the profile may be extended for a maximum of 6 months from the initial profile start date by the profiling officer.
(1) Temporary profiles exceeding 6 months duration, for the same medical condition, will be referred to a specialist (for that medical condition) for management and consideration for one of the following actions:
(a) Continuation of a temporary profile for a maximum of 12 months from the initial profile start date;
(b) Change the temporary profile to a permanent profile;
(c) Determination if the Soldier meets the medical retention standards of Chapter 3 and if not, referral to a MEB.
Army National Guard
10-15. Duty restrictions
a. Any recommendation for restricted activity that has been made by a private physician will be reported in writing, before performing any duty.
b. It is the individual Soldier's responsibility to report any medical problems immediately to the chain of command and to comply with medical restrictions. Commanders will honor the private physician's recommendations until the Soldier is evaluated by a military provider, and a recommended course of action is determined by a profiling officer (see para 7-6).
c. Soldiers and commanders will abide by the medical restrictions and limitations documented on any profile (DA Form 3349) issued.
New Executive Order
In February of 2012 a new executive order, EXORD 080-12, was issued to streamline the Integrated Disability Evaluation System (IDES). It is listed below:
EXORD 080-12 ARMY Disability Evaluation System (DES) STANDARDIZATION
REF/A/(U) Department of Defense Instruction (DODI) 1332.38/physical disability evaluation/01JUL06//
REF/b/(U) Directive-Type Memorandum (DTM) 11-015-Integrated Disability Evaluation System (IDES)/ 19DEC11//
REF/c/(U) Memorandum, Under Secretary of Defense for Personnel and Readiness, Integrated Disability Evaluation System Trainees/Recruits/Midshipmen/Cadets/30SEP11//
REF/d/(U) Policy Memorandum of Implementing Disability-Related Provisions of the National Defense Authorization Act of 2008 (Pub L. 110-181)/14OCT08//
REF/e/(U) ALARACT 148/2011: Overview of the Integrated Disability Evaluation System (IDES) for Installation Company/Detachment Pre-Command Courses (PCC) or Orientation/14APR11//
REF/f/(U) ALARACT 029/2011: Correction Copy to Integrated Disability Evaluation System (IDES) Implementation Plan/01FEB11//
REF/g/(U) ALARACT 011/2011: Integrated Disability Evaluation System (IDES) Implementation Plan/18JAN11//
REF/h/(U) Army Regulation 40-400. Patient Administration. 27Jan 10.
REF/i/(U) Army Regulation 40-501, Standards of Medical Fitness. 23 Aug 10.
REF/j/(U) Army Regulation 635-40, Physical Evaluation for Retention, Retirement or Separation. 8 Feb 06.
REF/k/(U) Army Regulation 40-68, Clinical Quality Management. 22 May 09.
REF/l/(U) Army Regulation 40-66, Medical Administration and Healthcare Documentation. 4 Jan 10.
REF/m/(U) MEDCOM POLICY Memo 10-062 MEDCOM Military Treatment Facility (MTF) Access to Care for Active Duty Service Members (ADSM), Including Warriors in Transition/26AUG10//.
1. (U) SITUATION.
1.A. Department of Defense (DoD) initiated the Integrated Disability Evaluation System (IDES) to streamline processes and procedures to ensure a seamless transition from military service to the Department of Veterans Affairs (VA) for continued care and entitlements. The Army lacks a standardized process for execution of IDES. Currently the process is governed by more than 50 policies, regulations, and procedures. As a result, questions have arisen concerning policies, definitions, timelines, and procedures that cause confusion in the field particularly for Soldiers going through the IDES process.
1.B. Based on the above challenges, the Vice Chief of Staff of the Army (VCSA) directed the development of a plan to standardize DES processes and improve efficiencies, from initiation of the first Temporary Profile, issuance of a permanent profile and a determination that a Soldier be either Returned to Duty (RTD) or medically separated or retired. The purpose of the plan is to establish a comprehensive document that sets standards, training requirements and procedures established through best practices for DES activities across the Army. Commands at all levels are directed to ensure that Soldiers are processed as efficiently as possible, receive counseling RELATED TO THE ANTICIPATED PROCESS AND TIMELINES and remain informed throughout the entire process.
1.c. IAW REFERENCE C, the Army will continue to exempt all Initial Entry Training (IET) members from the processes in annex a. With this exemption, enrollment in the VA’s Benefits Delivery at Discharge/Quick Start programs IS MANDATORY for TRAINEES AND RECRUITS WHO ARE eligible FOR REFERRAL TO THE DES AND WHO HAVE NOT COMPLETED INITIAL military TRAINING OR SIX MONTHS ON ACTIVE DUTY, WHICHEVER COMES FIRST. this is to ensure continued good order and efficiency at training centers.
1.D. Upon release of this EXORD the Army directs recommended changes to the disability evaluation system (des) be solicited and channeled through the G-1 LED des General Officer Steering Committee (GOSC). SHOULD THE DEPARTMENT OF DEFENSE ISSUE NEW DES POLICY, g-1 WILL SEEK RECOMMENDATIONS FROM THE GOSC TO ENSURE ALL NECESSARY PLANS ARE IN PLACE TO EXECUTE THE CHANGES.
2. (U) MISSION. the army will implement immediately the IDES attached as annex A as its DES at all levels of command in order to standardize the Army’s system for processing and transitioning soldiers who do not appear to meet medical retention standards.
3. (U) EXECUTION.
3.a.1. (u) The Army WILL define a standardized process of identification, referral, counseling and adjudication from point of injury illness or disease resulting in temporary profile which will lead to either to return to duty or transition from service. It is vital that the Army coordinates execution of the necessary changes at the strategic, operational, and tactical level to determine whether wounded, ill, or injured Soldiers are fit for continued military service and by which DoD and VA determine appropriate benefits for Service members who are separated or retired for a Service-connected disability.
3.a.2 (u) Until an end-to-end Information Technology (IT) solution/support for the DES is in place, the Veteran’s Tracking Application (VTA) will be used as the system of record for selected measures. All data points and measures that are currently available from the already existing systems must be leveraged to achieve efficiencies and quality outcomes. this will leverage available systems and data until an end-to-end solution is in place.
3.B. Key Tasks
3.B.1. Standardize the process to provide predictability and certainty for Soldiers entering the DES.
3.B.2. Facilitate leadership involvement at all levels of command by providing commanders and leaders real-time visibility of Soldiers throughout the process.
3.B.3. Establish standards and metrics for each phase of the DES.
3.B.4. Establish formal governance and oversight of the process.
3.B.5. Provide requirements to the Planning, Programming, Budgeting, and Execution System to sustain operations.
3.B.6. Communicate approved DES initiatives/programs to key audiences promoting understanding and support.
3.C Endstate: A standardized, efficient, evidence-based and resources informed DES process that enhances Army readiness and affords leaders greater visibility while providing a seamless transition to Soldiers, when necessary, from military service to VETERAN STATUS.
concept of the operation.
3.D.1. Temporary Profile Management Process (Pre-Medical evaluation Board (MEB)).
3.D.1.a. Soldiers with potentially unfitting conditions will be managed with Temporary 3 or 4 profiles through Medical retention determination point (MRDP) or Return to Duty (RTD). The eProfile application will be used to account for all temporary and permanent profiles recorded on DA Form 3349 (Physical Profile). Commanders at all levels must review temporary profiles using automated tools including Medical Protection System (MEDPROS) and e-Profile.
3.D.1.b. PER reference D, when a competent medical authority determines a soldier has one or more condition(s) which is suspected of not meeting medical retention standards, he or she will refer the soldier into the des at the point of hospitalization or treatment when a members progress appears to have medically stabilized (and course of further recovery is relatively predictable) and when it can be reasonably determined that the member is most likely not capable of performing the duties of his office, grade, rank or rating. referral will be within one year of being diagnosed with a medical condition(s) that does not appear to meet medical retention standards, but may be earlier if the examiner determines that the member will not be capable of returning to duty within one year.
3.D.1.C. THE SECOND SIGNATURE ON THE DA FORM 3349, FOR SOLDIERS THAT ARE ISSUED A PERMANENT PROFILE WITH A DESIGNATOR OF 3 OR 4 VALUE IN ANY OF THE PHYSICAL CAPACITY/UPPER EXTREMITIES/LOWER EXTREMITIES/HEARING/EYES/PSYCHIATRIC (PULHES) FACTORS FOR A DUTY RELATED CONDITION WHICH DO NOT MEET RETENTION STANDARDS, CONSTITUTES MRDP, REFERRAL INTO DES, AND THE START OF THE MEDICAL EVALUATION BOARD (MEB) PHASE.
3.D.1.D. THE SECOND SIGNATURE AUTHORITY WILL COMPLETE THE SECOND SIGNATURE ON THE PERMANENT PROFILE WITIHN SEVEN DAYS OF THE PROFILING PHYSICIANS SIGNATURE.
3.d.2. per annex a, the des process begins when, in consultation with the soldier’s commander and on approval by the meb convening authority, a military medical care provider refers a soldier to the des. PER ANNEX A, FOR SOLdiERS DETERMINED TO BE FIT, THE DES PROCESS CONCLUDES AT THE POINT OF RETURN TO DUTY (RTD); for soldiers determined to be unfit, the des process CONCLUDES for army purposes on the date of the soldier’s separation from the army. UNDER ANNEX A, THE DES CONSISTS OF A MEB PHASE, A PHYSICAL EVALUATION BOARD (PEB) PHASE, AND A TRANSITION PHASE.
3.d.3. MEB phase.
3.d.3.a PER ANNEX A, THE MEB phase commences WHEN A MILITARY MEDICAL CARE PROVIDER PROVIDES VA Form 21-0819 (VA/DoD Joint Disability Evaluation Board Claim) TO THE PHYSICAL EVALUATION BOARD LIAISON (PEBLO). THE MEB PROCESS concludes when the PHYSICAL EVALUATION BOARD (PEB) has received the case file CONTAINING ALL DOCUMENTS REQUIRED BY dA FORM 5889.
3.d.3.b. when the second signature is placed on da FORM 3349, PHYSICAL PROFILE, the second signature authority must immediately complete part 1 of VA Form 21-0819 verifying the referred condition(s) have been IDENTIFIED and within 72 hours transmit it to the supporting PEBLO.
3.d.4. PEB PHASE.
3.d.4.a. PER ANNEX a, the peb process commences when the MEB case file is received at the PEB. THE PEB PROCESS CONCLUDES WHEN THE PHYSICAL DISABILITY AGENCY (PDA) APPROVES THE FINAL RESULTS OF THE DISPOSITION DECISION.
3.d.4.b. PDA accomplishes administrative functions including updating eProfile for fit cases, uploading documents into iPERMS, and updating VETERAN’S TRACKING APPLICATION (VTA). PDA will ensure the PEBLO is notified when the case has been approved.
3.d.5. Transition phase. per annex a, THE TRANSITION PHASE BEGINS on the date the PDA, ON BEHALF OF THE sECRETARY OF THE ARMY, approves the final results of the disposition decision. the transition phase concludes on the date of the soldier’s separation from the army.
3.d.6. reintegration. for soldiers found to be fit, reintegration begins on the date the PDA approves the final results of the disposition decision. reintegration ends at the point of return to duty.
3.e. TASKS TO ARMY STAFF AND SUBORDINATE UNITS.
3.e.1 Department of the Army, G-1.
3.e.1.a. to ensure compliance with annex a, develop one consolidated regulation governing the management and adjudication of soldiers with duty-limiting conditions, including consolidating des and other administrative processes found in army regulations 40-66, 40-68, 635-40, 40-400, 40-501, 600-60 and any other applicable regulations. consolidation will include processes such as mar2, meb, peb, CONTINUATION ON ACTIVE DUTY/CONTINUATION ON ACTIVE RESERVE (coad/coar), transition, and reintegration. standards of medical fitness will remain under the proponency of the surgeon general.
3.e.1.b. identify pertinent army regulations requiring administrative update following the development of the consolidated regulation referenced in 3.e.1.a.
3.e.1.c. Revise pertinent forms associated with des process to synchronize the forms with the consolidated regulation.
3.e.1.d. Ensure that Soldiers WHO are non-deployable or have a TEMPORARY “3” (T-3) profile for greater than 30 days do not PROCEED ON PERMANENT CHANGE OF STATION (PCS) OR TEMPORARY CHANGE OF STATION (TCS) to units with a deployment order. Soldiers with MEDICAL READINESS CLASS (MRC) 3B will only PCS to a unit with a deployment order with a waiver approved by gaining Senior Commander. this is to stabilize medically non-deployable Soldiers.
3.e.1.e. Conduct complete analysis on how the DES will affect the ability of manning formations to meet manning targets if given the limitation of assigning Soldiers in DES to units with a deployment order. this is to provide Army leadership the impact of DES changes on unit readiness.
3.e.1.f. IN COORDINATION WITH (iCW) MEDCOM, facilitate the development of a training product, with combined arms center (cac) to be executed at the installation level, for Company CommanderFirst Sergeant course (CCFSC), on MEDPROS, eProfile, LINE OF DUTY (LOD) sTATEMENTS, etc. as mentioned in paragraph 3.e.3.a. this is to Ensure leaders receive uniform standardized training across the force.
3.e.1.g. identify functional INFORMATION TECHNOLOGY (it) requirements and current IT capabilities; submit the current year resourcing requirements to the da G-8/aSSISTANT SECRETEARY OF THE ARMY FOR FINANCIAL MANAGEMENT AND COMPTROLLER (FMC) ICW DA G-6 and MEDCOM. this is to ensure necessary IT resources to support THE DES are obtained and sustained.
3.e.1.h. in coordination with dod and VETERANS AFFAIRS (VA), Develop a system that will automate the DES from the initial Temporary 3 profile through Return to Duty/Transition, final orders processing and records archiving. Within 90 days present a proposal for the automated system. this is to ensure a fully automated enterprise-wide information management system.
3.e.1.i. Revise DA Form 5889 (PEB Transmittal Form) to reflect the current DES process within 60 days of the issuance of this EXORD. this is to standardize documentation requirements across the Army.
3.e.1.j. Ensure that no active duty Soldiers PCS/TCS once enrolled in the DES. this is to prevent delays in completing the DES process.
3.e.1.k. Adhere to MEB timeline standards as outlined in ANNEX A for individual mobilization augmentee (IMA) /individual ready reserve (IRR) Soldiers. IMA Soldiers will complete DES under the oversight of their TDA unit where they are assigned. IRR Soldiers will complete DES under the oversight of AHRC. this is to minimize delay of Soldier processing.
3.e.1.l. For IMA/IRR Soldiers, when the second signature is placed on the profile, the second signature authority must immediately complete VA Form 21-0819 and within 72 hours transmit it to applicable Senior PEBLO. this is to improve efficiency.
3.e.1.m. Identify specific AOCs and MOSs in the IMA/IRR population to augment current MEDCOM requirements. this is to augment and support surge requirements on Installations.
3.e.1.n. Develop a staffing model to determine PEB and PDA HQ personnel assets required to meet processing time standards outlined in ANNEX A based on caseload projections provided by MEDCOM in its predictive model. Brief the staffing model within 30 days of release of this EXORD. Provide staffing IAW the approved model. this is to ensure PEBs and PDA are adequately resourced to meet time standards.
3.e.1.o. Coordinate with DoD and VA to enable electronic transfer of Enterprise Content and document management capability between DA and VA. this is to Eliminate paper copy and streamline data management processes to improve case processing time.
3.e.1.p. Develop procedures to ensure PEBLOs are notified within 24 hours of cases being approved by the peb. PEBLOs are primary contact for Soldiers navigating the DES, and have the need to be informed when final PEB determinations are approved.
3.e.1.q. ICW PEB/Regional medical command (RMC) monthly meetings, action officer level participation by PDA, PEBs, MEDCOM PAD and RMCs will address issues related to case processing requirements, consistency of PEB requirements, and other case processing issues. this is to enhance communications between PDA and MEDCOM and identify and resolve issues related to PEB requirements.
3.e.1.r. Ensure that PDA loads fit finding code into eProfile within one day of case approval. this is to ensure timely and accurate eProfile data.
3.e.1.s. Ensure PEB and PDA meet all timelines as delineated in Annex A to this EXORD. this is to Standardize the process.
3.e.1.t. Within 30 days of release of this EXORD, publish guidance to require transition leave/PTDY in excess of 60 days be approved by the first Colonel in the Soldier’s chain of command. this is to ensure expeditious transition.
3.e.1.v. Develop a return-to-duty process for reintegration of soldiers found fit for duty.
3.e.1.w. develop a vta quality assurance plan.
3.e.1.x define des success and develop supporting metrics.
3.e.2. Department of the Army, G-6:
3.e.2.a. icw DA G-1 and MEDCOM, Assist to determine functional requirements and current capabilities.
3.e.2.B analyze, facilitate, and support the development of an end-to-end IT capability to properly support the DES. this is to ensure necessary IT resources to support DES are obtained and sustained.
3.e.3. army commands (ACOMs), army service component commands (ASCCs), and direct reporting units (DRUs).
3.e.3.a. Train all Company Commanders and First Sergeants on MEDPROS and eProfile to include password access; Commanders at all levels trained in the proper documentation of LODs and proper completion of DA Form 7652 prior to command or within 30 days of assumption of command. Already serving Commanders and First Sergeants are to complete this training within 90 days of the release of this EXORD.
3.e.3.B. Ensure monthly reviews are conducted by the Soldier’s Company Commander, Medical Authority, and Care Coordinator of all TEMPORARY “3” AND “4” (T3/4) profiles beginning 60 days after issuance of profile. Reviews will be conducted by the Battalion Commander at 120 days, brigade Commander at 180, and Senior Commander at 240 days. this is to ensure commanders oversight and visibility of the process and expeditious referral into DES or RTD.
3.e.3.c. Adhere to MEB timeline standards as outlined in ANNEX A. this is to minimize delay of Soldier processing.
3.e.3.d. Provide Borrowed Military Manpower via soldier skill set utilization program (s3up) for PEBLOs consisting of senior Non-Commissioned Officers and PEBLO Assistants (68W, 68G, 42A) to MEDCOM in support of DES. this will augment and support surge requirements on Installations.
3.e.3.e. Ensure assigned profiling officers take the online Medical Profiling course within 30 days of the release of this exord and prior to being granted access to eProfile. This task must be completed NLT 30 days after release of this EXORD. new profiling officers must take the online medical profiling course within 30 days of assuming the position and prior to being granted access to eprofile. this is to provide command visibility and to standardize the profiling process.
3.e.3.f. ensure soldier access to virtual capability to support Soldiers in MEB Phase and peb Phase of this DES EXORD. this will decrease the DES process timeline by utilizing virtual capabilities.
3.e.3.g. Commanders must ensure Soldiers attend all their required exit briefings as early as practical prior to departing on terminal/transitional leave or discharge. this is to ensure that the VA handoff is completed.
3.e.4. u.s. army training and doctrine command (tradoc).
3.e.4.a. comply with all tasks contained within paragraph 3.e.3.
3.e.4.b. TRADOC incorporate training on DES, eProfile, and MEDPROS into program of instruction of Standardized Company Commander/First Sergeant Course (CCFSC) with dedicated modules of instruction. this is To synchronize DES training across the Army.
3.e.5. army national guard (ArNG).
3.e.5.a. present A RECOMMENDED implementation plan on the management of medical readiness of arng Soldiers with T3/4 profiles to the Army G-1 led GOSC within 90 days of release of this EXORD. this is to ensure procedures are in place for management of arng Soldiers with T 3/4 profiles which will support Army requirements.
3.e.5.b. support MEDCOM request to meet current and surge requirements with units/individual Soldiers, as needed. this will augment and support surge requirements on Installations.
3.e.5.c. Train all Company Commanders and First Sergeants on MEDPROS and eProfile to include password access; Commanders at all levels trained in the proper documentation of LODs and proper completion of DA Form 7652 prior to command or within 30 days of assumption of command. Already serving Commanders and First Sergeants are to complete this training within 30 days of the release of this EXORD. If not already completed, Profiling Officers must complete the Medical Profiling Course within 30 days of the release of this EXORD. new profiling officers must take the online medical profiling course within 30 days of assuming the position and prior to being granted access to eprofile. this is to provide command visibility and to standardize the profiling process.
3.e.5.d. Ensure monthly reviews are conducted by the Soldier’s Company Commander, Medical Authority, and Care Coordinator of all T3/4 profiles beginning 60 days after issuance of profile. Reviews will be conducted by the BATTALION Commander at 120 days, BRIGADE Commander at 180, and Senior Commander at 240 days. this is to ensure commanders oversight and visibility of the process and expeditious referral into DES or RTD.
3.e.5.e. Adhere to MEB timeline standards as outlined in ANNEX A. this is to minimize delay of Soldier processing.
3.e.5.f. ensure When the second signature is placed on the profile, the second signature authority must immediately complete VA Form 21-0819 Part 1 which transfers the Soldier into DES, and within 72 hours transmit it to servicing DES organization. this will confirm transfer of the Soldier into DES.
3.e.5.g. Implement virtual capability to support Soldiers in THE MEB PHASE AND PEB PHASE of this IDES EXORD. this will decrease the DES process timeline by utilizing virtual capabilities.
3.e.5.h. Commanders must ensure Soldiers attend all their required exit briefings as soon as practical prior to discharge. this is to ensure that the VA handoff is completed.
3.e.5.i. Develop an rtd process for reintegration of soldiers found fit for duty.
3.e.5.j. develop a process for timely submission of all required medical and administrative documentation for the conduct of the meb in accordance with annex a timelines.
3.E.6. u.s. army reserve.
3.e.6.a. comply with all tasks contained within paragraph 3.e.3.
3.e.6.b. present recommended implementation plan on the management of medical readiness of army reserve Soldiers with T3/4 profiles to the Army G-1 led GOSC within 90 days of release of this EXORD. this is to ensure procedures are in place for management of usar Soldiers with T 3/4 profiles to support Army requirements.
3.e.6.c. support MEDCOM request to meet current and surge requirements with units/individual Soldiers, as needed. this will augment and support surge requirements on Installations.
3.e.6.d. Develop an rtd process for reintegration of soldiers found fit for duty.
3.E.6.E. develop a process for timely submission of all required medical and administrative documentation for the conduct of the meb in accordance with annex a timelines.
3.e.6.f. ensure When the second signature is placed on the profile, the second signature authority must immediately complete VA Form 21-0819 Part 1, which transfers the Soldier into DES, and within 72 hours transmit it to servicing DES organization. this will confirm transfer of the Soldier into DES.
3.e.7. U.S. Army Medical Command (medcom):
3.e.7.a. ASSIST g-1 WITH CONSOLIDATING REGULATIONS as referenced in para 3.e.1.a.
3.e.7.b. ensure da form 3349, physical profile, is updated for consistency with consolidated regulation.
3.e.7.c. Assist DA G-1 to facilitate the development of a training product, to be executed at the installation level for Company Commanders and First Sergeants at the local level on MEDPROS, eProfile, LODs, etc. this is to Ensure leaders are trained to standard.
3.e.7.d. Assist DA G-1 in determining functional requirements and current capabilities in the development of an end-to-end IT capability to properly support the DES. WHEN DETERMINING THESE REQUIREMENTS, ENSURE SOLDIERS’ LEGAL COUNSEL WILL BE ABLE TO TIMELY ACCESS NEEDED RECORDS ELECTRONICALLY AND TO file paperless rebuttals, IMR requests, PEB appeals and requests for VA Rating Reconsiderations. this is to ensure necessary IT resources to support DES are obtained and sustained.
3.e.7.e. Ensure MEB staff are trained in accordance with standards within ANNEX A. this is to standardize requirements for documenting MEB evidence for completion of the DES case file IAW PDA standards.
3.e.7.f. Within 30 days of publication of this EXORD establish a Soldier and Family-centered, multidisciplinary team approach to conduct the initial DES orientation appointment. Soldier’s appointment will occur within 14 days of initiation of the MEB. this is to provide the Soldier, their Family, and chain of command with a clear understanding of the DES process.
3.e.7.g. develop a validated staffing model for meb staff within 90 days of publication of this exord. this is to meet validated staff ratios in order to conduct DES process to standard.
3.e.7.h. Develop a mechanism to provide capacity for surge assistance if required. this is to provide flexible temporary staff augmentation capability to meet timelines during periods of high workload.
3.e.7.i. Provide AN APPROPRIATE NUMBER OF legal counsel in support of DES process. this is to ensure Soldiers receive due process while minimizing delays.
3.e.7.j. MEDCOM Commanders will ensure enhanced Access to Care for medically disqualifying condition(s) for all Soldiers in DES whether or not the soldier is in a warrior transition unit. this is to facilitate and expedite medical evaluation in support of DES case development.
3.e.7.k. Ensure all MEBs are submitted electronically using eMEB. Paper boards will not be submitted by the MILITARY TREATMENT FACILITIES (MTFs) nor accepted by the Physical Evaluation Boards (PEBs). this is to Eliminate duplicate data entry, ensure consistency in case processing, and decrease processing time.
3.e.7.l. ensure Commanders and Soldiers are notified of all VA scheduled appointments. this is To improve efficiency and reduce costs.
3.e.7.m. Within 60 days of release of this EXORD, establish a VA no-show rate tracking mechanism to provide no-show rates to Senior Commanders to keep rates below one (1) percent. this is to improve efficiency and reduce costs.
3.e.7.n. develop plan to Exploit all virtual capabilities (BH, NARSUM, MEB) to augment current staffing and support surge operations. this is to meet current and anticipated needs.
3.e.7.o. Provide visibility of Soldiers in the DES to Human Resources Command (HRC) through an administrative data system using Medical Readiness CLASSES (MRC). this is to ensure Soldiers with potential deployment-limiting conditions do not PCS to deploying units.
3.e.7.p. Within 90 days of publication of this EXORD, automate process within eProfile to complete part 1 of VA form 21-0819 and route to supporting PEBLO. this is to ensure timely electronic processing of required documents.
3.e.7.q. Ensure that PEBLOs coordinate the extension of Soldiers' EXPIRATION TERM OF SERVICE (ETS) dates or active duty orders, with the consent of the Soldier, to remain on orders during the MEB/PEB process. this is to Ensure Soldiers are not ETS or RELEASED FROM ACTIVE DUTY (REFRAD) while undergoing MEB/PEB process.
3.E.7.R. identify the volume of soldiers that will enter des based on unit mission, composition, and location over time. Create a predictive model based on the Army Force Generation Cycle that will support effective resourcing of des.
3.e.7.s. Develop a staffing model to determine Office of Soldier's Counsel (OSC) personnel assets required based on caseload projections provided by MEDCOM and DA G1 in their predictive model within 90 days of release of this EXORD. this is to ensure OSC is adequately resourced to support all Soldiers in the DES, through appeals at all levels, and is able to support VTCs at remote sites, at the Soldier’s election.
3.e.7.t. Ensure PEBLOs assist Soldiers WITH ADMINISTRATIVE PORTIONS OF REBUTTALS TO, AND APPEALS OF, INFORMAL PEB FINDINGS TO MEET 10-day standard. ensure that PDA cases that were returned to the MTF have all actions completed and submitted within 30 days to the PEB. this is to eliminate delays in processing of cases.
3.e.7.u. Within 90 days of release of this EXORD develop a plan to manage Temporarily Disabled Retired List (TDRL) workload that does not impact the DES process. this is to eliminate detractors from the DES Process.
3.e.7.v. SUPPORT arng AND usar IN THE developMENT OF a process for timely submission of all required medical and administrative documentation for the conduct of the meb in accordance with annex a timelines.
3.e.7.w. ensure When the second signature is placed on the profile, the second signature authority must immediately complete VA Form 21-0819 Part 1, which transfers the Soldier into DES, and within 72 hours transmits it to servicing DES organization. this will confirm transfer of the Soldier into DES.
3.e.8. U.S. Army Installation Management Command (imcom).
3.e.8.a. Support Senior Commanders in creating a common location for the DES Clinic. this is to enable co-location of assets involved in DES to maximize resource utilization, mission command and unity of effort.
3.e.8.b. Develop a facilities acquisition strategy to support DES requirements. this is to enable identify and mitigate facility shortfalls.
3.e.8.c. Ensure the DES Soldier and their Family has access to the Soldier Family Assistance Center (SFAC); determine if the SFAC will require additional resources for the additional workload. this is to ensure there are necessary resources available at the SFACs for Soldiers and their Families during the DES process.
3.e.8.d. TIMELY Issue separation/retirement orders for active duty Soldiers FOLLOWING receipt of the Transition Processing III (TRANSPROC) notification. this is to ENSURE COMPLIANCE WITH THE ANNEX A STANDARDS FOR THE TRANSITION PHASE.
3.e.9. OTJAG. PER ANNEX A, PEBLOS ARE REQUIRED TO PROVIDE SOLDIERS REFERRED TO THE DES WITH A BROCHURE OR HANDOUT DETAILING, AMONG OTHER ITEMS, THE SOLDIERS’ RIGHT TO LEGAL COUNSEL. OTJAG WILL COORDINATE WITH MEDCOM TO DEVELOP APPROPRIATE INFORMATIONAL MATERIALS TO COMPLY WITH THIS REQUIREMENT.
3.f. coordinating Instructions.
3.f.1. This EXORD authorizes execution.
3.f.2. Direct liaison is authorized to coordinate tasks.
3.f.3. U.S. Army Medical Command and DA G1 Physical Disability Agency conduct Mission Analysis to determine if additional requirements after release of this exord are necessary for timely completion of the DES.
3.f.4. The Army G-1 will recharter the Non-Deployability Campaign Plan GOSC to support the execution of the Army DES Standardization EXORD.
3.f.5. All units tasked in paragraph 3 of this exord must provide a LTC/COL to serve on a working group aligned under an Army G-1 led Army DES Standardization GOSC. the gosc will make recommended changes related to the des to G-1. All organizations must provide any proposed changes to the DES GOSC. invite asa(M&RA) to designate a representative to participate on the gosc.
3.f.6. THE REQUIRED PERFORMANCE STANDARDS ARE SET FORTH IN ANNEX A. METRICS IN SUPPORT OF THESE STANDARDS MUST BE CALCULATED IN ACCORDANCE WITH ANNEXES B AND c.
3.f.7. Time Line.
3.f.7.a. 1 march 2012 - 1 August 2012:
3.f.7.a.1. Monthly DES Working Group and GOSC established by the Army G-1 to track progress and make recommendations for process improvements.
3.f.7.a.2. every other Month 3-Star General Officer council to include DCG, FORSCOM, The Surgeon General, CAR, DARNG, and Army G1 (at a minimum). invite asa(M&RA) to designate a representative to participate on the council.
3.f.7.a.3. quarterly update of progress to VCSA.
3.f.7.a.4. NLT 6 MONTHS AFTER PUBLICATION OF THIS EXORD, THE DES GOSC WILL REVIEW COMPLIANCE with THE EXORD AND ANNEX A.
3.f.7.b. 1 August 2012 to a date TBD:
3.f.7.b.1. Monthly des working group meetings and gosc to track progress and implement changes.
3.f.7.b.2. Quarterly 3-Star General Officer steering committee will review progress.
3.f.7.b.3. semi-annual update to the VCSA.
3.f.7.b.4. icw medcom, aRMY G1 WILL CONDUCT AN Annual relook of implementation of ANNEX A across Army with inspections of installations and the Physical Disability Agency processes and timelines.
3.g. Commander’s Critical Information Requirements (CCIRs):
3.g.1. Requirements surpass capabilities for resources available at DES sites.
3.g.2. Events that would result in negative media attention.
3.g.3. Failure of Information Management/Information Technology
systems that degrade the tracking or transmission of data or slippage of timelines for delivery of required processes by more than 30 days.
4. (U) sustainment.
4.A. Support concept. The DES requires an integrated effort from the Army Staff, DoD, and VA organizations.
4.b. Critical to this plan is identifying the Table of Distribution and Allowances (TDA) for the MTFs, PDA, Office of Soldiers Counsel (MEDCOM), and Soldier Family Assistance Centers (SFAC) to meet the staffing requirements to achieve Full Operational Capability.
4.c. Priority of Support.
4.c.1. Personnel: Recommend appropriate changes to levels of personnel to support the current and projected workload of DES cases.
4.c.2. Facilities: identify any additional requirements needed to support the DES Clinic, SFACs and PEBs.
4.c.3. Equipment: Identify the requirements for all equipment and supplies required for establishing and maintaining the DES and any additional resources for the SFACs.
4.c.4. Funding: Identify Unfinanced Requirements for any aspect of the DES process and an estimate for the yearly costs to maintain operations.
5. (U) Command and signal:
5.A.1. DCS G-1 has overall Army Staff responsibility for the Army’s Disability Evaluation System. In coordination with TSG, the DCS, G-1 is responsible for reporting on the completion of the EXORD tasks to the VCSA.
5.A.2. ACOM/ASCC/DRUs responsible and accountable for resourcing, coordination, synchronization, and reporting performance with annexes a, b, and c from initial temporary profile issuance until mrdp (temporary profile management process).
5.a.3. TSG responsible and accountable for resourcing, coordination, synchronization, and reporting performance in accordance with standards from MRDP until completion of MEB PHASE.
5.A.4. CG, USAPDA responsible and accountable for coordination, synchronization, and reporting performance in accordance with standards from completion of MEB until completion of PEB PHASE.
5.A.5. ACOM, ASCC, DRUs, Army national guard, and u.s. army reserve are responsible and accountable for resourcing, coordination, synchronization, and reporting performance with standards from secretarial approval date to solDIer’s separation from the army.
5.b.1. HQDA G-1 POC is COL Daniel cassidy, usapda ahrc-d, com. 703-325-2726, email email@example.com.
5.b.2. medcom poc: col gregory swanson, mcho-cl-p, com. 210-221-6113, firstname.lastname@example.org.
5.b.3. arng POC: COL ANNE NACLERIO, arng-csg, COM. 571-214-2532, email@example.com.
5.B.4. usar poc: col sharon mckiernan, arrc-md, com. 910-570-8118, email firstname.lastname@example.org.
6. (u) this message will expire SIX MONTHS FROM PUBLICATION OF THIS EXORD.
Deputy Chief of Staff, G-3/5/7
A:DTM 11-015-IDES/ 19DEC11
B: The Army DES Standards
c: Performance Standards and Measures for the Conduct of the DES