Disabilities due to Injury in the U.S. Armed Forces
description
Transcript of Disabilities due to Injury in the U.S. Armed Forces
Learning and Performance Objectives
• Understand the spectrum of disability and the factors influencing it
• Identify the data sources for disability information in the U.S. Armed Forces and understand their strengths and limitations
• Identify the potential burden of injury-related disability
Disability in the United States10%
10%
80%
with a disability, not severewith a severe disabilitywith no disability
International Classification of Impairments, Disabilities, and Handicaps
Normal State
Disease
Impairment
Disability Handicap
Model of Functioning and Disability
Health Condition
ActivitiesBody Functions
Environmental Factors
Personal Factors
Participation
Disability in the Armed Forces
Permanent disability
Temporary disability
Discharge from activeduty with or without
compensation
- Not fit for active duty
- To be re-evaluatedover time
Discharge return to duty
Sources of Disability Data
• Disability Agencies
• Physical Evaluation Boards
• Medical Evaluation Boards
• Line-of-Duty Reports
• Individual research reports
Identifying Injury-Related Disability
• VASRD codes - diagnostic codes for a wide spectrum of diseases and physical impairments covering all major body systems
• ICD-9-CM codes - diagnostic codes used to describe the nature of the medical condition and cause of an injury
Categories of Disability
• Permanent disability – a permanent disability resulting in discharge with full compensation.
• Separation with severance pay – disability resulting in discharge with separation pay.
• Separation without benefits – disability resulting in discharge without pay
• Temporary disability – a medical disability that could change over time; not fit for active duty
• Fit for duty – return for active duty
Incidence of Disability in the Armed Forces
0
10
20
30
40
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
Rat
e p
er 1
000
per
son
nel
/yea
r
Army Navy Air Force
Disposition of disability cases,1994
Army
8,413
Navy
10,786
Air Force
3,687
Permanent disability 16% 4% 15%Separation with pay 41% 61% 19%Separation - no benefits 4% — 2%Temporary disability 15% 22% 23%Fit for duty 24% 5% 41%Other — 8% —
Total Number
Medical conditions associated with disability
Total Number
Army
6,382
Navy
7,682
Air Force
3,687
Orthopedic/musculoskeletal 53.1 % 63.0 % 22 %
Mental disorders 14.2 9.7 21Neurologic/convulsive 12.1 9.3 13Systemic/respiratory 7.4 6.4 14Blood/skin/endocrine 3.3 3.5 12Cardiovascular system 3.4 2.7 6Digestive system 2.9 2.5 5Visual/auditory conditions 1.7 1.7 2
Top 10 diagnoses of musculoskeletal and connective tissue disorders, US Naval
MEB reports%Joint disorders 23.1
Back disorders 16.6Internal derangement of knee 11.8Other derangement of joint 7.7Intervertebral disc disorders 7.4Muscle/ligament disorders 4.8Other bone/cartilage disorders 4.5Osterarthrosis 4.3Peripheral enthesopathies 3.8Other disorders of soft tissue 3.4
Top 10 injury diagnoses, Naval MEB reports
Dislocation of knee 13.8 %Sprains/strains of knee/leg 9.3 %Ankle fracture 6.7 %Fracture of tibia and fibula 5.1 %Fracture of tarsal/metatarsal 4.3 %Fracture of vertebral column 3.8 %Sprains/strains of ankle and foot 3.7 %Fracture of radius and ulna 3.5 %Shoulder dislocation 2.9 %Fracture of carpal bones 2.8 %
Top 10 Reasons for MEB review in an Army Infantry Division, 1994
0 2 4 6 8 10 12
Diabetes
Disc Disorder
Psychiatric
Knee Disorder
Low Back Pain
Rate per 1000 personnel Percent
Knee Pain
Asthma
Flat Feet
Arm/Hand Fracture
Vascular Disease
200400
60080010001200
140016001800
80 81 82 83 84 85 86 87 88 89 90
(mil
lion
s of
dol
lars
)
Severance PayTemporary Disability
Permanent DisabilityTotal
Disability compensation costs paid by the military departments fiscal year 1980-1990.
Discussion
• Physical disability rates in the Armed Forces are at higher levels this decade than seen in the previous decade
• 30% to 50% of disability cases could be due to injury
• Most disability cases under review result in discharge from active service
The information reviewed suggests that: