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Tables of Contents for Methods & Actions for Improving Performance of the Department of Defense Disability Evaluation System
Preface
iii
Figuresix
Tablesxi
Questions of Interest Regarding the Disability Evaluation System
2
1
Organization of This Report
4
1
Background on the Disability Evaluation System
5
8
Training as a Central Focus of This Study
5
2
Findings and Recommendations from Previous Studies of the Disability Evaluation System
7
6
Medical Disability Discharge Procedures (June 8, 1992)7
1
Preliminary Functional Economic Analysis (November 1993)8
1
Disability Payments to Military Personnel (December 1989)9
1
Follow-up Audit of Disability Payments to Military Personnel (Decemberl994)10
1
The Veterans' Claims Adjudication Commission Report to Congress Pursuant to Public Law 103-446 (December 1996)11
2
Disability Evaluation System Overview
13
30
Purpose Statement and Desired Outcomes
13
2
The Organizational Setting
15
4
The Elements of the Disability Evaluation System16
1
Organizational Location17
2
System Operating Framework Across Departments: Overview of the Disability Evaluation Phases
19
24
Medical Evaluation and Disposition by the Medical Evaluation Board21
6
Physical Disability Evaluation and Disposition27
12
Appellate Review and Disposition Beyond the Physical Evaluation Board39
2
Final Disposition by the Appropriate Personnel Authorities41
2
Issues and Interventions for Achieving Consistent Policy Application
43
26
Goal Fabric Analysis Overview
44
2
Applying Goal Fabric Analysis to Resolve Identified Issues
46
20
Assistant Secretary of Defense Decisions Intervention48
2
Policy Guidance Intervention50
2
Organizational Intervention52
2
Personnel Policy Intervention54
1
Personnel Management Intervention55
1
Training Intervention56
5
Information Source Development Intervention61
2
Management Information System Deployment Intervention63
1
Process Intervention64
2
Incentives Intervention66
1
A Paradigm Shift: From Ensuring Consistent Policy Application to Improving System Performance
66
3
Disability Evaluation System Training Analysis and Recommended Changes In Training to Improve System Performance
69
42
Bodies of DES-Specific Knowledge
70
13
Current Disability Evaluation Training Within the Department of Defense71
2
Target Population73
4
Competencies Derived from Desired Outcomes77
4
Training Content: DES Topics81
2
DES-Specific Knowledge Needed Immediately Upon Assignment83
1
Frequency with Which Primary Participants Apply DES-Specific Bodies of Knowledge84
1
Assignment Practices Causing High Turnover Rates Among Some Primary Participants85
1
Widely Dispersed Primary Participant Populations85
1
Military Department DES Web Sites85
1
Advantages and Disadvantages of Self-Directed Computer-Based Distance Training and Classroom Training86
3
Department of Defense Training Recommendations
89
22
Recommendations for Self-Directed Computer-Based Distance Training90
14
Recommendations for Classroom Training104
7
Monitoring System Performance
111
20
The Need for a Management Information System
112
2
Assessing the Performance of the Disability Evaluation System
114
4
Developing an Integrated Set of Performance Measures
118
4
Process Improvements Intervention119
1
Enhanced Primary Participant Competency Intervention119
1
A Framework for Integrating Outcome and Output Performance Measures120
2
Implementing a Measurement System
122
9
General Observations122
2
A Set of Metrics124
7
Costs and Benefits of Training
131
12
Cost of Self-Directed Computer-Based Distance Training133
2
Cost of Classroom Training135
1
Quantifiable Benefits136
4
Nonquantifiable Benefits140
1
Study Objectives, Approach, and Recommendations
143
4
Systems Perspective of the Disability Evaluation System
147
2
Other Applications of the Issues-Based and Purpose-Driven Analytic Approaches
149
1
Suggestions for Future Study
150
1
A. Overview of the Office of the Under Secretary of Defense and Organizational Responsibility for the Disability Evaluation System
151
6
B. Military Department Interpretations of the Purpose of the Disability Evaluation System
157
4
C. Disability Evaluation System Issues
161
6
D. Example of Goal Fabric Analysis Development
167
6
E. Relating Actions to Objectives
173
14
F. Comparing the Issues-Driven and Purpose-Driven Analytic Approaches
187
4
G. Disability Evaluation System Training Topics for Primary Participant Populations Across Military Departments
191
12
H. Description of Metrics for Assessing Disability Evaluation System Performance
203
10
I. Cost-Benefit Analysis Data
213
6
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