“Non-Duty” Disability Evaluation System (DES) Process Robert C. Desko, MD, FACS Col, USAF, SFS Deputy Director, ANGMS Clinical and Operational Medicine

NDAA 2011 ‘‘§ 1214a. Members determined fit for duty in Physical Evaluation Board evaluation: prohibition on involuntary administrative separation due to unsuitability based on medical conditions considered in evaluation”

NDAA 2011 2011 NDAA (HR6523 section 1214A) prohibits ARC members from being administratively discharged without SecDef approval when they have been found “fit for military duty,” but not world-wide duty (WWD) qualified (signed 7 Jan 2011) DoDI 1332.14 Enlisted Administrative Separations (30 Sep 2011), implements this policy The Air National Guard position is that ANG forces are funded and postured to be deployed to bare base locations throughout the world The Air Force Reserve position is: There are enough deployment locations to accommodate Reservists who are in a stratified Assignment Limitation Code (ALC-C)

“NON-DUTY” DISABILITY EVALUATION SYSTEM (DES) PROCESS Member identified with a “Non-Duty” physical disqualification MDG – will initiate top half of DAWG Checklist and AF Form 469 (Code 31, only) with remarks statement: Member has been identified with a “Non-Duty” physical disqualification that must be processed through the Non-Duty Disability Evaluation System (DES) to continue his/her military service. Forms will be forwarded to the FSS FSS – Meets with member; reviews (AF Form 469, DAWG checklist, and FSS forms) Question: Does member wish to undergo the “Non-Duty” Disability Evaluation System (DES)? Member will read and sign the Statement of Selection form NO YES Mbr works with FSS/MDG on “Non-Duty” DES package MDG – Receives the Statement of Selection form, changes AF Form 469 to (Code 37) and completes the “Non-Duty” DES medical package Process member for Sep/Ret due to a “Non-Duty” physical disqualification Clarification of Air National Guard (ANG) non-duty disability and separation processing procedures in response to the National Defense Authorization Act for FY 2011 as codified in 10 U.S.C. Section 1214a A non-duty physical disqualification is defined as a medical or dental condition incurred while not in a duty status that results in a physical disqualification in accordance with AFI 48-123 An ANG member with a non-duty physical disqualification must be processed through the Non-Duty Disability Evaluation System (DES) to continue his/her military service An ANG member with a known physical disqualification who refuses to comply with a request for medical information or evaluation is considered medically unfit for continued military duty and will be referred to his or her immediate commander by the MDG for administrative discharge processing IAW AFI 36-3209 Once the MDG has identified a non-duty physical disqualification and initiated an AF Form 469, Duty Limiting Condition Report, with a Code 31, the ANG member shall have two options: 1. Decline review by the Non-Duty DES. IAW AFI 36-3209, para 2.16 or 3.14, involuntary separation processing will then be initiated based upon the physical disqualification. a. If the member is retirement-eligible, after discharge proceedings are initiated, he or she will be afforded the opportunity to apply for retirement in lieu of discharge.   b. If the member is a Federal Technician he/she may qualify for the early retirement option due to the physical disqualification.   2. Elect review by the Non-Duty DES. This choice gives the member a higher level of review for his or her case, however, the result will only be a finding of “fit” or “unfit” with no monetary or disability benefits available. The MDG will change the Code 31 to a Code 37 on the AF Form 469 and assemble a package to be forwarded to NGB/SG for review and adjudication. The package will include:   Initial DAWG “Non-Duty” DES Checklist.  AF Form 469.   Statement of Selection Letter.   Commander Letter.   Medical/Psych Narrative Summary and supporting medical documentation. Upon completion of DES package the MDG will forward to NGB/SG for fitness determination

“NON-DUTY” DISABILITY EVALUATION SYSTEM (DES) PROCESS Upon completion of DES package the MDG will forward to NGB/SG for fitness determination NGB/SG – Determines member is FIT and Returned to Duty No Restrictions NGB/SG – Finds the member UNFIT for military duty Non-Duty DES package is forwarded to HQ AFPC (IPEB) for Fitness Determination NGB/SG – Determines member is FIT and Returned to Duty With Restrictions Member Returned to Duty (AF Form 469 cleared) NGB/SG Non-Duty DES Findings. a. If the NGB/SG finds the member unfit, the package shall be sent to HQ AFPC for an Informal Physical Evaluation Board (IPEB).   1. If the IPEB finds member unfit, member may opt to submit an appeal to the Formal Physical Evaluation Board (FPEB) or be involuntarily separated.   2. If the IPEB finds the member fit with restrictions, NGB/SG shall determine the appropriate Assignment Limitation Code-C (ALC-C) stratification and NGB/A1 will enter it into the Personnel Data System (PDS). b. If NGB/SG finds the member fit without restrictions, the member is returned to duty. c. If NGB/SG finds the member fit with restrictions, NGB/SG shall determine the appropriate ALC-C stratification and NGB/A1 will enter it into the PDS. NGB/SG - Establishes ALC-C Code (1, 2, or 3) NGB/A1 – Updates ALC-C Code (1,2, or 3) in PDS ALC-C Codes (1, 2, or 3) must be re-evaluated by NGB/SG yearly or upon expiration (established by NGB/SG) DES Processing

Assignment Limitation Code (ALC-C) ALC-C Stratification Assignment Limitation Code (ALC-C) ALC-C1 (Worldwide (mobility) Qualified) Designates members with temporary or mild conditions. Medical follow-up is required but the condition is clinically quiescent, unlikely to cause serious impact if untreated, or treatment is limited to primary care during periods of deployment or assignment ALC-C2 (Worldwide (mobility) Qualified) Designates members with medical conditions that will likely require specialist medical care and referral within one year. The member could be deployed or reassigned to OCONUS environments for short periods of time or if limited medical facilities offer the appropriate specialty medical care ALC-C3 (Worldwide (mobility) NOT Qualified) Designates members who should not be deployed or assigned to locations where the specialty medical care required to manage their unique medical condition is not available A member with an ALC-C will have assignments and deployments restricted to CONUS, Alaska (Elmendorf), and Hawaii. A waiver for reassignment or deployment anywhere else requires coordination between the MDG, NGB/SG, and possibly the gaining MAJCOM. a. The intent of the ALC-C is to both protect members with serious conditions from being placed in an environment without adequate medical care and to prevent the assignment of non-qualified personnel to austere locations.   b. NGB/SG may assign one of the following ALC-C codes based on risks and medical requirements.   ALC-C1 (Worldwide (mobility) Qualified) Designates members with temporary or mild conditions. Medical follow-up is required but the condition is clinically quiescent, unlikely to cause serious impact if untreated, or treatment is limited to primary care during periods of deployment or assignment. ALC-C2 (Worldwide (mobility) Qualified) Designates members with medical conditions that will likely require specialist medical care and referral within one year. The member could be deployed or reassigned to OCONUS environments for short periods of time or if limited medical facilities offer the appropriate specialty medical care. ALC-C3 (Worldwide (mobility) NOT Qualified) Designates members who should not be deployed or assigned to locations where the specialty medical care required to manage their unique medical condition is not available. NGB/SG retains sole authority to assign or remove the ALC-C on ANG members. The ALC-C will be valid indefinitely, but should be reviewed by the Deployment Availability Working Group (DAWG) and renewed at least annually, unless otherwise specified by NGB/SG. ANG Medical Group Commanders are responsible for tracking and keeping Commanders updated on their members who have ALC-Cs and must also assure timely medical review as specified by NGB/SG during the time-frame indicated.

Non-Duty DES Process Questions?