Who may apply? PHYSICAL DISABILITY BOARD OF REVIEW

Transcription

Who may apply? PHYSICAL DISABILITY BOARD OF REVIEW
WHAT TO KNOW IF YOU ARE ELIGIBLE FOR THE
PHYSICAL DISABILITY BOARD OF REVIEW
Who may apply?
If you:
• Were medically separated
between September 11, 2001
and December 31, 2009
• Have a combined DoD
awarded disability rating of
20% or less
• Were not previously found
eligible for a DoD disability
retirement
You are eligible to request a
review of your disability ratings.
Note: Former reserve members
with greater than 20 years of
Total Federal Military Service
yet with fewer than 20 years of
Active Duty and who meet the
criteria listed above are also
eligible.
How to apply:
A qualified service member, their
surviving spouse, next of kin, or
legal representative must submit
a signed form DD 294 to the PDBR
Central Intake Unit in San Antonio,
TX. The form can be downloaded
at: www.dtic.Mil/Whs/Directives/
Infomgt/Forms/Eforms/Dd0294.Pdf
Marines medically separated as a result of a Department of the Navy
Physical Evaluation Board determination since September 11, 2001
have the opportunity to have their disability ratings reviewed by
the Physical Disability Board of Review (PDBR) to ensure fairness
and accuracy. Upon application, the PDBR will examine each
applicant’s medical separation, compare Department of Defense
(DoD) and Department of Veterans Affairs (VA) ratings, and make a
recommendation to the Secretary of the Navy that could result in a
change in benefits.
In more than half of the cases reviewed by the PDBR (as of
April 2011), the applicant’s Service has agreed with the PDBR
recommendation. If determined that you should have been
medically retired, you will be placed on the Temporary / Permanent
Disability Retired List (TDRL / PDRL). You should expect to see
your retirement certificate / orders within 8–12 weeks. The same
approval letter corrects your DD-214 to reflect disability retirement
on a DD-215.
What does this mean for you and your family if your application to
the PDBR is successful?
1 You will receive (retroactive to the day of your original disability
separation) monthly disability retirement pay. NOTE: By law, all
previously awarded disability pay must be offset from these new
retirement payments before you can actually begin receiving
any new disability retired pay (this includes the original disability
severance pay you may have been awarded from your military
service department as well as any VA disability pay you’ve
received – explicitly for the disability for which you are now
being retired).
2 You (and your eligible dependents) will have all rights and
privileges of a retired Veteran (e.g. commissary, exchange, space
available recreation and travel, other benefits available via State
and private sector organizations).
3 You are eligible to enroll in the Survivor’s Benefit Plan insurance
for your dependents (you would be responsible for paying
insurance premiums to bring your coverage up to date).
4 You would be eligible for DoD’s TRICARE health care coverage
(retroactive to the day of your original disability separation).
Coverage is extended to your eligible dependents as well.
Previous medical expenditures incurred by you MAY BE
retroactively reimbursed by TRICARE.
Receiving Retroactive Reimbursement for Medical Expenses
Once eligibility is established for TRICARE, contact the appropriate
TRICARE Regional Office and request assistance through the claims
division. A “reasonable time” exception (which is normally one
year) will be made for retirees who are retroactively retired through
the PDBR process. TRICARE requires copies of all medical expenses
incurred by the member from the time he/she separated up to when
the member was formally approved for retirement. Note: Significant
collection and gathering of documents will need to take place on the
part of the member prior to initiating these claims.
Frequently Asked Questions
How is the review conducted?
The applicant will not appear in person, but may
include any statements, briefs, medical records or
other supporting documents with the application.
After the document review is completed and final
decision is made, each applicant will be notified of
the decision and any further information regarding
a change of rating.
What CAN the PDBR do?
The PDBR can recommend:
1. No change to the separation or the combined
disability rating previously assigned.
2. Re-characterization of the separation to
retirement for disability.
3. Modification of the combined disability rating
previously assigned. The PDBR may not reduce
the disability rating previously assigned.
If the PDBR determines that a previous “fit”
determination should be changed to “unfit,” the
PDBR shall make the recommendation and assign
a rating to that condition which will be combined
with the other disability rating(s).
The PDBR recommends, but who directs
action on the final decision?
The Secretary of the Navy shall accept or reject,
in whole or in part, the recommendation of the
PDBR within 45 days of PDBR recommendation.
Notification of the decision shall be provided within
10 days. If accepted, notification shall include
the effect (medical retirement or separation with
severance pay) and effective date. In those cases
where a record change is warranted resulting from
an increase of a rating and/or retirement, the VA
will be notified of the change. The Secretary will
direct the Marine Corps to complete the actions
approved.
Who can I contact if I have questions on the
PDBR process or my status?
HQ Marine Corps Disability Section for
Separations/Retirements (MMSR-4): 703-7849308/9309/9321
WWR Sergeant Merlin German Wounded Warrior
Call Center: 1-877-487-6299
PDBR Intake Unit: 703-325-0874 / 0870
What if I do not receive my monthly retired
paycheck or have other problems concerning
my pay?
Contact DFAS Retired Pay and Annuities at 1-800321-1080.
How do I take advantage of/enroll in the
benefits for which I’m now eligible?
1. Take your retirement certificate / orders or
DD-215 to any DEERS / RAPID site to enroll
and / or update DEERS information prior to
enrolling in TRICARE and getting you blue
retiree and dependant ID cards.
2. Obtain a DoD decal for access to any/all on
base privileges at base security.
3. Complete DD form 2656 for DoD Survivor
Benefit Plan (SBP). Note: Please read through
the information carefully before electing or
declining. If no election is made within 90 days
of the receipt of the approval letter, DFAS will
automatically provide coverage and reduce any
retired pay to cover the premium costs.
4. Complete DD form 2860 for Combat Related
Special Compensation (CRSC) (Marines
with combat related injuries only). CRSC
is retroactive to 1 January 08 for Marines
who retired prior to 1 January 08. Visit the
Wounded Warrior Regiment website for a fact
sheet on CRSC.
THE WOUNDED WARRIOR REGIMENT
The Wounded Warrior Regiment (WWR) stood up in April 2007 and immediately began to assume responsibilities for non-medical
wounded warrior care. The mission of the WWR is to provide and facilitate assistance to wounded, ill and injured (WII) Marines,
sailors attached to or in direct support of Marine units, and their family members, throughout the phases of recovery. The Regimental
Headquarters element, located in Quantico, Va., coordinates the operations of two Wounded Warrior Battalions located at Camp
Pendleton, Calif., and Camp Lejeune, N.C. The Regimental Headquarters provides unity of command and unity of effort through a
single Commander who provides guidance, direction, and oversight to the Marine Corps WII non-medical care process and ensures
continuous improvements to care management and the seamless transition of recovering Marines.
UNITED STATES MARINE CORPS WOUNDED WARRIOR REGIMENT
ETIAM IN PUGNA “STILL IN THE FIGHT”
www.woundedwarriorregiment.org • 877.487.6299 •
0413EXTLPDBR