Trends in Department of Defense Disability Evaluation System Ratings and Awards for Posttraumatic Stress Disorder and Traumatic Brain Injury, 2002—2017 : RAND Corporation , 2021
From the preface: "Service members whose wounds, illnesses, or injuries call into question their ability to fulfill their military duties may be referred by a health care provider or commanding officer to the joint U.S. Department of Defense (DoD)–U.S. Department of Veterans Affairs (VA) Integrated Disability Evaluation System (IDES). During the evaluation, the military department in which the individual serves determines whether he or she is fit for duty. If the service member is found to be unfit, the service member is medically discharged from military service. Since 2001, there have been major changes to disability evaluation policies and processes, as well as policy changes related to screening, diagnosing, and treating what have become known as the “signature wounds” of the wars in Iraq and Afghanistan: posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). To explore these changes, as well as their potential effects on the numbers and characteristics of service members who are evaluated through IDES, the DoD asked the RAND National Defense Research Institute (NDRI) to assess trends in DoD Disability Evaluation System (DES) policies and awards for PTSD and TBI between 2002 and 2017. This report documents historical trends in disability evaluations and outcomes for service members with PTSD or TBI and compares those trends with those for service members with other medical conditions. A companion report (RR-3173-OSD) describes RAND NDRI’s review of DES policies and changes to the way DoD screened for and identified PTSD and TBI between 2001 and 2018. The research reported here was completed in August 2019 and underwent security review with the sponsor and the Defense Office of Prepublication and Security Review before public release."