Army Physical Disability Evaluation System: Time for an Overhaul, Not an Analysis

2010 ◽  
Author(s):  
Steve D. Elliott
Keyword(s):  
Physical Disability ◽  
Evaluation System ◽  
Disability Evaluation ◽  
System Time

Tri-service Disability Evaluation System Database Review Annual Report 2010

2011 ◽  
Author(s):  
David W. Niebuhr ◽  
Marlene E. Gubata ◽  
David N. Cowan ◽  
Elizabeth R. Packnett ◽  
Caitlin D. Blandford ◽  
...  
Keyword(s):  
Evaluation System ◽  
Annual Report ◽  
Disability Evaluation ◽  
System Database

Hip Arthroscopy for Femoroacetabular Impingement in a Military Population

2017 ◽  
Vol 45 (14) ◽  
pp. 3298-3304 ◽  
Author(s):  
Darren D. Thomas ◽  
Andrew S. Bernhardson ◽  
Ethan Bernstein ◽  
Christopher B. Dewing
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Evaluation System ◽  
Disability Evaluation ◽  
Case Series ◽  
Active Duty ◽  
Military Population ◽  
Level Of Evidence ◽  
Vas Scores ◽  
The Military

Background: Femoroacetabular impingement (FAI) can lead to hip pain and early joint degeneration. There have been few reports to date on the outcomes of hip arthroscopy for the treatment of FAI in the military population. Purpose/Hypothesis: The purpose of this study was to compare patient demographics with postoperative outcomes after hip arthroscopy for symptomatic FAI and to identify preoperative risk factors for poor outcomes. The hypothesis was that certain preoperative patient characteristics will be predictive of poorer outcomes and that lower outcomes scores will be associated with a higher likelihood of medical separation from the military. Study Design: Case series; Level of evidence, 4. Methods: Retrospective chart review of active-duty and dependent patients older than 18 years who underwent hip arthroscopy for symptomatic FAI from 2009 to 2014 at a single institution. Results: A total of 469 (309 males and 160 females) surgeries were performed on 456 active-duty personnel and 13 dependent civilians, with a mean 2.5-year follow-up. Overall, 39% (n = 179) were able to return to duty (RTD), 18% (n = 82) were medically cleared to return to normal daily activities but did not remain on active duty, and 43% (n = 195) required referral to the Disability Evaluation System (DES). Increasing rank and male sex were positive predictors and Axis 1 psychiatric diagnosis, revision surgery, concomitant psoas tenotomy, multiple medical comorbidities, and complaints of generalized pelvic pain were negative predictors for returning to duty. US Marine Infantry and Special Forces showed improved RTD rates (50%-86%) compared with administrative, more sedentary, occupations (22%). On average, Single Alpha Numeric Evaluation (SANE) and visual analog scale (VAS) scores improved after surgery, with SANE scores improving 37 ± 28 points and VAS scores improving 2.6 ± 2.5 points. The mean postoperative SANE and VAS scores differed significantly between the RTD group and those not returning to duty; 87 and 1.2 points compared with 69 and 3.6 points, respectively ( P < .0001). Conclusion: Hip arthroscopy for the treatment of symptomatic FAI effectively improves pain symptoms and self-reported overall function but shows a much lower than expected return to full, unrestricted active duty in the general active-duty military population. Underlying psychiatric diagnoses, female sex, and more sedentary occupations are associated with lower RTD rates. Furthermore, lower postoperative SANE and VAS scores are associated with lower RTD rates. Only the more active and elite components of the military study population showed RTD rates consistent with previously reported outcomes of return to competitive sports after hip arthroscopy for FAI.

scholarly journals Development and validation of the ICF-CY-Based Functioning Scale of the Disability Evaluation System—Child Version in Taiwan

2015 ◽  
Vol 114 (12) ◽  
pp. 1170-1180 ◽  
Author(s):  
Ai-Wen Hwang ◽  
Chia-Feng Yen ◽  
Tsan-Hon Liou ◽  
Gary Bedell ◽  
Mats Granlund ◽  
...  
Keyword(s):  
Evaluation System ◽  
Disability Evaluation ◽  
Development And Validation

scholarly journals Disability Status Attenuates Treatment Effects in an Intensive Outpatient Program for PTSD

2021 ◽  
Vol 186 (Supplement_1) ◽  
pp. 190-197
Author(s):  
Tim Hoyt ◽  
Brianna E Staley Shumaker
Keyword(s):  
Evaluation System ◽  
Disability Evaluation ◽  
Skills Training ◽  
Ptsd Symptoms ◽  
Military Health ◽  
Ptsd Treatment ◽  
Outpatient Program ◽  
Intensive Outpatient Program ◽  
Program Enrollment ◽  
Intensive Outpatient

ABSTRACT Introduction The utilization of intensive outpatient programs for the treatment of military-related post-traumatic stress disorder (PTSD) has increased through initiatives both inside and outside the military health care system. However, research in veteran populations suggest that patients concurrently undergoing disability evaluation may not respond well to such interventions. This study evaluates the relationship between disability separation and endorsement of PTSD symptoms during treatment at an intensive outpatient program. Methods Patients in this retrospective study were 81 service members enrolled in a half-day, 6-week intensive outpatient program for PTSD. Sixty-seven percent (n = 54) were concurrently enrolled in the integrated disability evaluation system and were pending medical separation. Fifty-two percent (n = 42) also received a 4-week skills training intervention before beginning PTSD treatment. Patients completed the PTSD Checklist before, during, and after the treatment program as an index of PTSD symptoms. Results A significant interaction effect was observed in which PTSD symptoms throughout program enrollment differed as a function of enrollment in the integrated disability evaluation system. Patients undergoing disability evaluations did not show significant changes in endorsed PTSD symptoms during program enrollment, whereas significant decreases in PTSD symptoms were observed in patients not undergoing disability evaluations. These effects controlled for lost treatment days as a result of training or other appointments. Conclusions These results provide preliminary data indicating that participation in disability separation may attenuate the effect of PTSD treatment and endorsement of PTSD symptoms in an intensive outpatient setting.

scholarly journals Necessity of developing a disability evaluation guideline

2021 ◽  
Vol 64 (8) ◽  
pp. 519-521
Author(s):  
Ho Seong Lee
Keyword(s):  
American Medical Association ◽  
Medical Association ◽  
American Medical ◽  
Physical Disability ◽  
Disability Evaluation ◽  
Medical Society ◽  
Limited Resources ◽  
Medical Sciences ◽  
Standard Guideline

Background: Although doctors expend their best effort in treating their patients’ illnesses or injuries, the patients may retain some disabilities even after treatment. Accordingly, some conflicts occur between the patients’ expectations of financial compensation for their disabilities and the financial manager’s policy to efficiently distribute limited resources. The mediation of these social conflicts requires the determination of the degree of physical disability, which can be done by doctors alone. Hence, a reliable disability evaluation guideline should be established. However, currently, only a few educational programs on disability evaluation are available for doctors and there is no reliable guideline for disability evaluation.Current Concepts: There were attempts to implement the American Medical Association guideline in Korea; however, it is currently not being used efficiently because it is quite complicated and unsuited to Korean settings. Mcbride’s disability evaluation, published 60 years ago, is being used, but it is not realistic and unreasonable in Korea. To prepare a standard guideline for disability evaluation, the Korean Academy of Medical Sciences published a booklet, “Disability Evaluation Guideline: Explanation and Case Studies”, based on the American Medical Association guideline. The academy published the booklet’s revised version (2nd edition), ‘Disability evaluation guideline and utilization’, in 2016. However, Korean Academy of Medical Sciences guideline still not being used because it is too complicated to use.Discussion and Conclusion: Fair disability evaluation is a social responsibility given to doctors, and there should be a useful guideline for disability evaluation that reflects the characteristics of each medical society or association.

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