As of August 2019, there are approximately 19 million veterans in the United States. Twenty-five percent of those, a total of 4.7 million, have a service-connected disability. Twenty-Six percent of disabled veterans have a disability rating below 30 percent and 44 percent have a disability rating above 60 percent.
Veterans who became medically separated from the military between the dates of September 11, 2001, and December 31, 2009, are eligible to have their disability undergo a review by the Physical Disability Board of Review (PDBR).
The PDBR success rate shows 17 percent of the cases reviewed received disability compensation. This includes retroactive benefits. Less than 30 percent of the veterans eligible for a review have gone through the application process.
In this article about the VA PDBR:
- What is PDBR?
- The PDBR Review Eligibility
- PDBR Application Process
- Filing the Application
- PDBR Review Process
- Benefits to You and Your Family
- PDBR Appeal
- Other Information about the PDBR
- Contact Woods and Woods for Disability Benefits Claims and Appeals
What is PDBR?
PDBR’s creation is due to the Dignified Treatment of Wounded Warriors Act of 2008 (DTWWA), signed into law on January 28, 2008. This new law includes several changes regarding the care of wounded veterans.
A very important change is the requirement that all military branches must use the same rating system for determining a soldier’s disability. Any veteran with a disability that is service-connected receives a rating by the U.S. Department of Veterans Affairs or the U.S. Department of Defense.
The VA rating scale is from 0 to 100 percent in 10 percent increments. The more severe the disability, the higher the percentage rate assigned.
The DTWWA also expanded the treatment a veteran receives following a disabling injury received in service. Treatment is available in both civilian and military facilities. This includes Post-Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI).
The fourth change the DTWWA made was that it required the Secretary of the Department of Defense (DoD) to develop a review board. The purpose of the board is to review a veteran’s disability determinations to ensure it meets specific criteria and timeline requirements.
That review board is the Physical Disability Board of Review (PDBR). The Board provides veterans the opportunity to have their disability rating reviewed. To be eligible the medical separation needs to have occurred between the dates of September 11, 2001 and December 31, 2009.
The PDBR Review Eligibility
The mandate of the PDBR is to review the fairness and accuracy of the disability ratings that service members received. Those eligible for review must meet specific criteria:
- At the time of separation, the veteran received a combined disability rating of less than 20 percent
- The veteran’s separation took place between September 11, 2001 and December 31, 2009, due to being unfit for continuing military service
- The original finding was that the veteran was not eligible for retirement, including reserve component service members
If you are a former reserve member and have served in the federal military in excess of 20 years and active duty for less than 20 years, you are eligible to apply if you meet the criteria above.
There are a wide number of conditions that can qualify you for Veteran Disability Benefits. Prior to 2008, the DoD had published instructions for the evaluation and rating to use in determining a service member as Unfit for Duty. A soldier who is Unfit for Duty is not capable of performing their duties, including:
- Wear their gear and equipment
- Perform their military obligations
- Meet the physical fitness requirements
- Perform the requirements of their job
- Be deployed
The instructions were not consistent with the VA rating system. They also left it open to the discretion of each branch of service on how to apply those instructions and determine ratings. Service members from different military branches suffering similar injuries may have different ratings.
This was unfair, and the passing of the Dignified Treatment of Wounded Warriors Act of 2008 led to the Veterans Affairs Schedule for Rating Disabilities (VASRD) being the only acceptable system for rating disabilities.
If you are a veteran who received a medical separation from the military after December 31, 2009, your review rating is based on the VASRD. Those ratings do not need a PDBR review.
PDBR Application Process
There is no PDBR timeline cut-off for requesting a PDBR review. You can visit the Physical Disability Board of Review website to learn how to apply and access the DD 294 application form.
In addition to the eligibility criteria noted above, you must be able to answer the following:
- Whether you were permanently separated from your service in the military after September 10, 2001, but before January 1, 2010
- Whether a disability was the reason for your separation from military service
- If the disability rating you received at the time of your permanent separation was less than 30 percent combined
- Whether at the time of your permanent separation from military service for disability you were not otherwise eligible for a military retirement
If you are able to confirm all of the above you meet the eligibility requirements to apply for a PDBR review.
The only medical evidence the PDBR takes into consideration is the records leading to the date of separation. They will also consider post-separation documentation for up to 12 months following separation. Post-separation documentation only applies if it confirms the severity of your condition on the date of separation.
You should only submit medical records that are pertinent to the period of time prior to your separation from the military. Submitting too many records can lead to important ones being inadvertently overlooked.
Filing the Application
The application can be filed either through the mail or electronically. You will need to:
- Download and complete DD Form 294
- Even if you do not have all information requested, you need to mail or submit the completed form electronically
- Send the form with a copy of your Discharge from Active Duty or Certificate of Release, DD Form 214 or DD Form 215 (submit the application even if you do not have your release paperwork
PDBR Review Process
The Physical Disability Board of Review handles the review of cases for all branches of the military: Marines, Coast Guard, Army, Air Force, Marines, Navy, and their reserves.
The review is conducted by representatives of three separate branches of the military, including one from the branch in which the veteran served.
The purpose of the review is to determine whether the veteran’s disability award should have a higher combined rating. This is accomplished through a review of documents including:
- The veteran’s medical records prior to joining the military
- The medical records from the veteran’s military record
- Letters from the veteran’s family members regarding the veteran’s injury or illness
- Letters from the veteran’s military colleagues regarding the veteran’s injury or illness
- A statement from the veteran
- A current health screening of the veteran
The condition review and rating recommendation are based on the veteran’s conditions at the time he/she left the military. This means if the disability is worse than at the time of discharge, the current condition is not considered. The only consideration is the severity on the date of discharge.
After comparing all records along with the Veteran’s Administration and DoD ratings, the PDBR makes a recommendation to the military branch the veteran served in. The recommendation states whether their review indicates a veteran’s disability rating should be changed. The final decision on whether or not to make that change is at the discretion of the veteran’s military branch.
The law does not allow the PDBR to recommend a lower rating. It also requires that any disability ratings that are changed to a higher level must be backdated. The new effective date must match the original Physical Evaluation Board date.
Approximately 50 percent of the cases the PDBR reviews result in the veteran receiving an upgraded disability determination. This upgrade changes their medical separation to disability amount.
Benefits to You and Your Family
If the final determination is to change your rating to a higher level, you may receive PDBR back pay retroactive to the date of your original disability separation.
You may receive an award of monthly disability pay. This pay will be retroactive back to the date of your original medical discharge. The retroactive amount is calculated as a lump sum payment and then your monthly disbursement will be at the higher rate moving forward.
The law does not allow veterans to receive both VA disability and military medical retirement pay. Any prior disability severance pay you received from the VA and DoD must be offset before you receive the new payment award.
This is done on a $1 for $1 equalization where the retirement pay is not paid to you, but the disability payments are. In other words, the previously received amount is deducted from the new amount due.
The retroactive computations require a significant amount of research and calculations. Because of the extensive amount of work necessary, it may take 60 to 90 days before receiving retroactive pay.
This is an excellent change in rating because military retirement pay is taxable. The VA disability pay is tax-free.
DoD’s TRICARE Health Care Coverage
The DoD’s TRICARE coverage you may be eligible for extends back retroactively to your original disability separation date. The coverage is also available to your eligible dependents. Once you have approval, you may request reimbursement of any prior medical expenses.
Survivor’s Benefit Plan Insurance
You may now be eligible to purchase the Survivor’s Benefit Plan Insurance. If you purchase this plan you will be responsible for paying the insurance premiums retroactively to bring the coverage up to date.
Privileges and Rights of Retired Veteran
The PDBR review may provide you and your eligible dependents privileges and rights equal to those of a retired Veteran from your military branch. These include space-available travel and recreation, exchange, and commissary. You will also be eligible for any privileges provided by private companies or states.
One of the key components to a successful appeal is presenting case law in legal briefs. Legal research is tricky and it is not always easy to locate and cite legal precedent that may sway the case in your favor.
There is nothing within the military that provides an appeal process if you do not agree with the PDBR decision. You may want to consult with an attorney who specializes in appeals regarding military decisions. They may be able to file an appeal in a higher court or know of additional options available.
Woods & Woods does not handle PDBR decisions. Our area of practice is in appealing VA disability benefits decisions.
Other Information about the PDBR
A review of your disability ratings may positively impact your veteran’s unemployability benefits. Here is additional information frequently requested by veterans or their families about PDBR reviews:
- If the veteran is incapacitated or deceased, the veteran’s spouse, legal guardian, or next of kin may request a PDBR.
- If you apply for a PDBR you can not request a service BCMR/BCNR review on your rating level for the same medical condition that led to your separation.
- You can request a BCMR/BCNR review of your rating for other medical conditions that were not the cause of your separation.
- The government will not pay for you to pay for an attorney to advise you on your PDBR Review.
- You can not attend your PDBR review, it is a document review only.
- Your service and medical records remain secure, only persons who need to know will have access to your information.
- The PDBR will only review and adjudicate your rating one time.
- The veteran will receive a letter of determination that includes the rationale for the decision.
- If requested at the time of application, the PDBR will review some or all of your other medication conditions listed on your military MEB/PEB.
Contact Woods and Woods for Disability Benefits Claims and Appeals
Although we do not handle PDBR cases, we are available for a free consultation if you have a medical diagnosis for a condition you believe was caused by or aggravated by your military service. We also appeal disability benefits decisions. The consultation is free. The initial application process is free. You pay zero attorney fees unless we win your disability benefits claim.
Scheduling a consultation is easy. Simply fill out our online form or call us toll-free at (866) 232-5777.
Here, one of our VA disability lawyers talks about what we do when we appeal your case to the Veteran’s Administration.