Summary
Service members found unfit for duty due to a service-related illness or injury may be eligible for military disability retirement. When their disability is not stable, however, they may be placed on the military's Temporary Disability Retired List (TDRL) and granted temporary benefits for as long as 5 years. GAO was asked to respond to concerns about TDRL caseloads, management, and impact on servicemembers. To address these concerns, we analyzed TDRL data; interviewed military officials; reviewed laws, regulations, and other relevant documents; and conducted 12 focus groups with temporary retirees. This report examines (1) recent trends in the TDRL caseload size, (2) recent trends in the characteristics of those placed on the TDRL, (3) disability retirement outcomes for TDRL placements, (4) the adequacy of TDRL management, and (5) the adequacy of information provided to TDRL retirees.
TDRL caseloads within the Department of Defense (DOD) grew by 43 percent, from 9,983 in fiscal year 2003 to 14,285 in fiscal year 2007. Growth in caseloads could be attributable to a combination of increases in the number of cases going through the military's disability evaluation system, higher TDRL placement rates, and low numbers of cases removed from the TDRL relative to new cases added to the list. DOD-wide, servicemembers placed on the TDRL in each calendar year from 2000 through 2007 varied little with respect to their military status, years of service, and disabilities. In each of these years, most TDRL placements had been active duty personnel, although the small proportion who had been reservists grew considerably. Most TDRL placements in each year also had fewer than 20 years of service and, over time, their average years of service declined. The disabilities most prevalent among TDRL placements were musculoskeletal, mental, or neurological in nature. Among those with mental and neurological disabilities, the incidence of post traumatic stress disorder and conditions related to traumatic brain injury increased substantially across the services. Although the experiences of temporary disability retirees varied, some outcomes were more common than others. DOD-wide, very few who were placed on the list between calendar years 2000 and 2003 returned to military service. Further, about half received a final determination within 3 years and, of those who ultimately received permanent disability benefits, 73 percent had final disability ratings that were no different than their initial ratings. Finally, only 7 percent of TDRL placements, DOD-wide, received a final disability rating that qualified them for permanent disability payment amounts higher than their TDRL payments. DOD and the services do not effectively manage key aspects of the TDRL process. The military does not systematically examine physical evaluation board (PEB) stability decisions for accuracy and consistency or routinely compile information on TDRL outcomes to better inform its assessments of stability. According to TDRL administrative staff, ensuring that medical reexaminations are done in TDRL cases at least once every 18 months is often a challenge. However, the military does not monitor the extent to which this requirement is met. Moreover, there is limited use of nonmilitary physicians to perform reexaminations, which could reduce burdens on medical treatment facilities. Finally, military procedures do not ensure consistent enforcement of TDRL rules. Information about the TDRL that the services provide is not always clear or complete and can be difficult to access. PEB findings forms provided to temporary retirees do not fully explain why service members are placed on the list or what is required of them. Temporary retirees reported that counseling related to PEB decisions was inconsistent and lacking in followthrough. Information from military pamphlets, brochures, fact sheets, and Web sites is often incomplete or difficult to find. Temporary retirees participating in our focus groups expressed considerable confusion about and dissatisfaction with their limited access to information and points of contact.
Recommendations
Our recommendations from this work are listed below with a Contact for more information. Status will change
from "In process" to "Implemented" or "Not implemented" based on our follow up work.
Director:
Team:
Phone:
Daniel Bertoni
Government Accountability Office: Education, Workforce, and Income Security
(202) 512-5988
Matters for Congressional Consideration
Recommendation: Given the low number of temporary retirees who return to the military, the high proportion who eventually become eligible to receive permanent military disability retirement benefits, and the added cost to the military of administering TDRL cases, the Congress may wish to consider shortening the current 5-year maximum tenure on the TDRL.
Status: In process
Comments: When we determine what steps the Congress has taken, we will provide updated information.
Recommendations for Executive Action
Recommendation: To ensure that TDRL placement and retention decisions are appropriate and consistent, the Secretary of Defense should direct the Secretaries of the Air Force, Army, and Navy to better inform their decisions about whether or not to place or retain someone on the TDRL by taking into account data from past TDRL cases on outcomes for particular types of disabilities.
Agency Affected: Department of Defense
Status: In process
Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Recommendation: To ensure that TDRL placement and retention decisions are appropriate and consistent, the Secretary of Defense should systematically review the appropriateness and consistency of each service's PEB decisions regarding the stability of disabilities.
Agency Affected: Department of Defense
Status: In process
Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Recommendation: To ensure that TDRL reexaminations occur at least once every 18 months, the Secretary of Defense should direct each service to track and periodically report on the timeliness of medical reexaminations in TDRL cases.
Agency Affected: Department of Defense
Status: In process
Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Recommendation: To ensure that TDRL reexaminations occur at least once every 18 months, the Secretary of Defense should develop DOD-wide standards and goals for the timeliness of TDRL reexaminations.
Agency Affected: Department of Defense
Status: In process
Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Recommendation: To ensure that TDRL reexaminations occur at least once every 18 months, the Secretary of Defense should establish a clearer policy specifying how the services should enforce the requirements that temporary retirees submit to periodic reexaminations and notify TDRL administrators when they have a change of address.
Agency Affected: Department of Defense
Status: In process
Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Recommendation: To ensure that TDRL reexaminations occur at least once every 18 months, the Secretary of Defense should expand the use of nonmilitary physicians for conducting TDRL reexaminations, in accordance with DOD guidance.
Agency Affected: Department of Defense
Status: In process
Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Recommendation: To prevent unnecessary delays in permanent disability determinations for temporary retirees and gaps in the receipt of disability benefits they are entitled to, the Secretary of Defense should direct the services to ensure that temporary retirees receive a final determination upon expiration of their 5 years on the TDRL, as required by law.
Agency Affected: Department of Defense
Status: In process
Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Recommendation: To ensure that temporary retirees receive adequate information to understand why they are placed on the list and the importance of complying with TDRL requirements, the Secretaries of the Air Force, Army, and Navy should assess the adequacy of information they provide regarding the TDRL, including the information contained on their PEB findings forms and other materials, and provided by PEBLOs, and make improvements where needed.
Agency Affected: Department of Defense: Department of the Air Force
Status: In process
Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Agency Affected: Department of Defense: Department of the Navy
Status: In process
Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Agency Affected: Department of Defense: Department of the Army
Status: In process
Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Recommendation: To ensure that temporary retirees receive adequate information to understand why they are placed on the list and the importance of complying with TDRL requirements, the Secretaries of the Air Force, Army, and Navy should take steps to encourage ongoing contact between temporary retirees and TDRL administrators by, for example, maintaining a working and easily accessible TDRL administrative telephone hotline for temporary retirees.
Agency Affected: Department of Defense: Department of the Air Force
Status: In process
Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Agency Affected: Department of Defense: Department of the Navy
Status: In process
Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Agency Affected: Department of Defense: Department of the Army
Status: In process
Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Recommendation: To ensure that temporary retirees receive adequate information to understand why they are placed on the list and the importance of complying with TDRL requirements, the Secretaries of the Air Force, Army, and Navy should improve access to Web-based information about the TDRL.
Agency Affected: Department of Defense: Department of the Air Force
Status: In process
Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Agency Affected: Department of Defense: Department of the Navy
Status: In process
Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Agency Affected: Department of Defense: Department of the Army
Status: In process
Comments: When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
