Methods and Actions for Improving Performance of the Department of Defense Disability Evaluation System 2002

by Marcum, Cheryl Y.; Emmerichs, Robert M.; Sloan, Jennifer S.; Thie, Harry J.

• ISBN13: 9780833030108
• ISBN10: 0833030108
• Format: Paperback
• Copyright: 2002-05-07
• Publisher: RAND Corporation

Summary

This book focuses on four major research tasks related to improving system performance: developing a basis for assessing DES outcomes, identifying issues of variability in DES policy application, conducting a DES training analysis and presenting recommended changes, and developing a method for continuously monitoring DES performance.

Table of Contents

Preface	iii
Figures	ix
Tables	xi
Summary	xiii
Acknowledgments	xxv
Acronyms	xxvii
Introduction	1	(4)
Questions of Interest Regarding the Disability Evaluation System	2	(1)
Research Approach	3	(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)
External Customers	15	(1)
The Organizational Setting	15	(4)
The Elements of the Disability Evaluation System	16	(1)
Organizational Location	17	(2)
System Operating Framework Across Departments: Overview of the Disability Evaluation Phases	19	(24)
Medical Evaluation and Disposition by the Medical Evaluation Board	21	(6)
Physical Disability Evaluation and Disposition	27	(12)
Appellate Review and Disposition Beyond the Physical Evaluation Board	39	(2)
Final Disposition by the Appropriate Personnel Authorities	41	(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 Intervention	48	(2)
Policy Guidance Intervention	50	(2)
Organizational Intervention	52	(2)
Personnel Policy Intervention	54	(1)
Personnel Management Intervention	55	(1)
Training Intervention	56	(5)
Information Source Development Intervention	61	(2)
Management Information System Deployment Intervention	63	(1)
Process Intervention	64	(2)
Incentives Intervention	66	(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)
Methodology	70	(1)
Bodies of DES-Specific Knowledge	70	(13)
Current Disability Evaluation Training Within the Department of Defense	71	(2)
Target Population	73	(4)
Competencies Derived from Desired Outcomes	77	(4)
Training Content: DES Topics	81	(2)
Training Design	83	(6)
DES-Specific Knowledge Needed Immediately Upon Assignment	83	(1)
Frequency with Which Primary Participants Apply DES-Specific Bodies of Knowledge	84	(1)
Assignment Practices Causing High Turnover Rates Among Some Primary Participants	85	(1)
Widely Dispersed Primary Participant Populations	85	(1)
Military Department DES Web Sites	85	(1)
Advantages and Disadvantages of Self-Directed Computer-Based Distance Training and Classroom Training	86	(3)
Department of Defense Training Recommendations	89	(22)
Recommendations for Self-Directed Computer-Based Distance Training	90	(14)
Recommendations for Classroom Training	104	(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 Intervention	119	(1)
Enhanced Primary Participant Competency Intervention	119	(1)
A Framework for Integrating Outcome and Output Performance Measures	120	(2)
Implementing a Measurement System	122	(9)
General Observations	122	(2)
A Set of Metrics	124	(7)
Costs and Benefits of Training	131	(12)
General Assumptions	132	(1)
Costs	133	(2)
Cost of Self-Directed Computer-Based Distance Training	133	(2)
Cost of Classroom Training	135	(1)
Benefits	135	(6)
Quantifiable Benefits	136	(4)
Nonquantifiable Benefits	140	(1)
Training Results	141	(2)
Conclusions	143	(76)
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)
Appendix
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)
Bibliography	219