Growth in TDRL caseloads could be related to a  combination of increases in the number of cases going through the  military’s disability evaluation system, higher TDRL placement rates, and  low numbers of cases removed from the TDRL relative to numbers of new  cases being added to the list. The Characteristics of TDRL Placements Have Changed Somewhat in Recent Years

DOD-wide, servicemembers placed on the TDRL in each calendar year  from 2000 through 2007 varied little with respect to their military status,  years of service, and most prevalent disabling conditions. In each of these  years, most TDRL placements had been active duty personnel, although  the small proportion who had been reservists grew considerably between  2000 and 2007. Most TDRL placements in each year also had fewer than 20  years of service and, over time, their average years of service declined,  DOD-wide. The disabilities most prevalent among TDRL placements have  consistently been musculoskeletal, mental, or neurological in nature. Among those with mental and neurological disabilities, the incidence of  Post Traumatic Stress Disorder (PTSD) and residual conditions related to  traumatic brain injury (TBI) increased substantially across all of the  services. Very Few TDRL Placements Returned to Military Service, Half Received a  Final Determination within 3 Years, and Many Received a Final Disability  Rating Identical to the Initial Rating  While there are variations in TDRL results across the services, some  outcomes for this group were more common than others. Finally, only 7 percent of TDRL placements, DOD-wide,  received a final disability rating that would have resulted in permanent  disability payment amounts higher than their TDRL payments. 5.) DOD-wide, for those placed on the TDRL in calendar years 2000  through 2003 who were ultimately placed on the PDRL, 73 percent were  assigned a final disability rating that was no different from their initial  disability rating. They also do not routinely compile information on TDRL outcomes that  could better inform PEB determinations related to the stability of  disabilities. Despite indications that the services face challenges providing  medical reexaminations at least once every 18 months as required by law,  none monitor the extent to which this requirement is met. Moreover,  although TDRL reexamination requirements can place burdens on TDRL  retirees and MTFs, the use of examinations by nonmilitary physicians to  reduce these burdens is limited. The Services’ Procedures Do Not Ensure Consistent Enforcement of TDRL Rules

DOD requires temporary retirees to submit to a periodic medical  examination at least once every 18 months. TDRL Information Is Not Always Adequate or Accessible to Temporary Retirees

Information about temporary disability retirement that the services  provide to those they place on the TDRL is not always clear or complete  and can be difficult for TDRL retirees to access. The official PEB findings  forms, themselves, do not fully explain the reason for an individual’s  placement on the list or what is required of the TDRL retiree. TDRL retirees  participating in our focus groups expressed considerable confusion about  and dissatisfaction with their limited access to information and contacts. To ensure that temporary retirees receive adequate information to  understand why they are placed on the list and the importance of  complying with TDRL requirements, we recommend that the Secretaries of  the Air Force, Army, and Navy take the following three actions:    Assess the adequacy of information they provide regarding the TDRL,  including the information contained on their PEB findings forms and  other materials, and provided by PEBLOs, and make improvements  where needed; take steps to encourage ongoing contact between temporary retirees  and TDRL administrators by, for example, maintaining a working and  easily accessible TDRL administrative telephone hotline for temporary  retirees; and  improve access to Web-based information about the TDRL. Appendix I: Scope and Methodology

The objectives of our review were to examine (1) recent trends in the  Temporary Disability Retired List (TDRL) caseload size, (2) recent trends  in the characteristics of servicemembers placed on the TDRL, (3) disability  retirement outcomes for TDRL placements, (4) the adequacy of TDRL  management, and (5) the adequacy of information provided to temporary  retirees.
Why GAO Did This Study

Service members found unfit for duty due to a service-related illness or injury may be eligible for military disability retirement. When their disability is not stable, however, they may be placed on the military's Temporary Disability Retired List (TDRL) and granted temporary benefits for as long as 5 years. GAO was asked to respond to concerns about TDRL caseloads, management, and impact on servicemembers. To address these concerns, we analyzed TDRL data; interviewed military officials; reviewed laws, regulations, and other relevant documents; and conducted 12 focus groups with temporary retirees. This report examines (1) recent trends in the TDRL caseload size, (2) recent trends in the characteristics of those placed on the TDRL, (3) disability retirement outcomes for TDRL placements, (4) the adequacy of TDRL management, and (5) the adequacy of information provided to TDRL retirees.

What GAO Found

TDRL caseloads within the Department of Defense (DOD) grew by 43 percent, from 9,983 in fiscal year 2003 to 14,285 in fiscal year 2007. Growth in caseloads could be attributable to a combination of increases in the number of cases going through the military's disability evaluation system, higher TDRL placement rates, and low numbers of cases removed from the TDRL relative to new cases added to the list. DOD-wide, servicemembers placed on the TDRL in each calendar year from 2000 through 2007 varied little with respect to their military status, years of service, and disabilities. In each of these years, most TDRL placements had been active duty personnel, although the small proportion who had been reservists grew considerably. Most TDRL placements in each year also had fewer than 20 years of service and, over time, their average years of service declined. The disabilities most prevalent among TDRL placements were musculoskeletal, mental, or neurological in nature. Among those with mental and neurological disabilities, the incidence of post traumatic stress disorder and conditions related to traumatic brain injury increased substantially across the services. Although the experiences of temporary disability retirees varied, some outcomes were more common than others. DOD-wide, very few who were placed on the list between calendar years 2000 and 2003 returned to military service. Further, about half received a final determination within 3 years and, of those who ultimately received permanent disability benefits, 73 percent had final disability ratings that were no different than their initial ratings. Finally, only 7 percent of TDRL placements, DOD-wide, received a final disability rating that qualified them for permanent disability payment amounts higher than their TDRL payments. DOD and the services do not effectively manage key aspects of the TDRL process. The military does not systematically examine physical evaluation board (PEB) stability decisions for accuracy and consistency or routinely compile information on TDRL outcomes to better inform its assessments of stability. According to TDRL administrative staff, ensuring that medical reexaminations are done in TDRL cases at least once every 18 months is often a challenge. However, the military does not monitor the extent to which this requirement is met. Moreover, there is limited use of nonmilitary physicians to perform reexaminations, which could reduce burdens on medical treatment facilities. Finally, military procedures do not ensure consistent enforcement of TDRL rules. Information about the TDRL that the services provide is not always clear or complete and can be difficult to access. PEB findings forms provided to temporary retirees do not fully explain why service members are placed on the list or what is required of them. Temporary retirees reported that counseling related to PEB decisions was inconsistent and lacking in followthrough. Information from military pamphlets, brochures, fact sheets, and Web sites is often incomplete or difficult to find. Temporary retirees participating in our focus groups expressed considerable confusion about and dissatisfaction with their limited access to information and points of contact.