Para ver o descargar la norma entera, haga clic en su enlace, que está dentro de la casilla que se encuentra arriba de estos comentarios.

"DES" significa el "Disability Evaluation System" (sistema de evaluación de discapacidad).
Aquí dice que para que las fuerzas armadas separe (discharge) a alguien por discapacidad, un médico tiene que mandar el caso a un tribunal de evaluación médica (Medical Evaluation Board o MEB) y éste tiene que mandar el caso a un tribunal de evaluación física (Physical Evaluation Board o PEB).
La separación se basa únicamente en motivos médicos.

DoD Directive 1332.18 (December 1, 2003)

3. POLICY

It is DoD policy that:

...

3.2. The DES shall consist of four elements: medical evaluation; physical disability evaluation, to include appellate review; counseling; and final disposition.

3.3. The sole standard to be used in making determinations of unfitness due to physical disability shall be unfitness to perform the duties of the member's office, grade, rank or rating because of disease or injury. In addition, retirement or separation because of physical disability requires determinations that the disability:

3.3.1. Further:

3.3.1.1. In the case of a member on active duty for more than 30 days, was incurred while the member was entitled to basic pay, or any other member of the Armed Forces, after September 23, 1996, who is on active duty but is not entitled to basic pay under 37 U.S.C. 502(b) (reference (g)) due to authorized absence to participate in an educational program, or for an emergency purpose, as determined by the Secretary concerned; or

3.3.1.2. In the case of a member on active duty for 30 days or less, is the proximate result of, or was incurred in line of duty after September 23, 1996, as a result of:

3.3.1.2.1. Performing active duty or inactive duty training;

3.3.1.2.2. Traveling directly to or from the place at which such duty is performed; or

3.3.1.2.3. After September 23, 1996, an injury illness, or disease incurred or aggravated while remaining overnight, between successive periods of inactive duty training, at or in the vicinity of the site of the inactive duty training, if the site is outside reasonable commuting distance of the member's residence.

3.3.2. Is of a permanent nature.

3.3.3. Was not the result of intentional misconduct or willful neglect and was not incurred during a period of unauthorized absence.

...

3.8. The assignment of disability ratings shall be based on the Veterans Administration Schedule for Rating Disabilities (VASRD) (reference (h)) as implemented by reference (e) and DoD Instruction 1332.39 (reference (f)).

Para ver o descargar la norma entera, haga clic en su enlace, que está dentro de la casilla que se encuentra arriba de estos comentarios.
Esta sección define todos los términos que se usa en la norma.
Esta sección describe los detalles del proceso de evaluación de discapacidad.

































Esta sección describe las afecciones en las cuales se puede basar una separación por discapacidad.




























































































































Esta sección describe las afecciones en las cuales no se puede basar una separación por discapacidad.

DoD Instruction 1332.38 (July 10, 2006)

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E2. ENCLOSURE 2
DEFINITIONS

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E3. ENCLOSURE 3
PROCEDURES

E3.P1. ENCLOSURE 3 PART 1 OPERATIONAL STANDARDS FOR THE DES

E3.P1.1. Overview of the DES. Under the supervision of the Secretary concerned, each DES shall consist of four elements:

E3.P1.1.1. Medical evaluation by Medical Evaluation Boards (MEBs), Ready Reserve physical examinations, and TDRL periodic physical examinations.

E3.P1.1.2. Physical disability evaluation by Physical Evaluation Board (PEBs), to include appellate review.

E3.P1.1.3. Service member counseling.

E3.P1.1.4. Final disposition by appropriate personnel authorities.

E3.P1.2. Medical Evaluation

E3.P1.2.1. Purpose. The medical evaluation element of the DES shall document under departmental regulations the medical status and duty limitations of Service members referred into the DES.

...

E3.P1.3. Physical Disability Evaluation

E3.P1.3.1. Purpose. The physical disability evaluation element of the DES shall determine the fitness of Service members with medical impairments to perform their military duties; and for members determined unfit for duty-related impairments, their entitlement to benefits under Chapter 61 of 10 U.S.C. (reference (b)). Physical disability evaluation shall be conducted by PEBs and include the elements in subsections E3.P1.3.2. through E3.P1.3.5., below.

E3.P1.3.2. Informal PEB. The informal PEB will conduct a documentary review without the presence of the Service member for providing initial findings and recommendations.

E3.P1.3.3. Formal PEB. Eligible Service members shall be provided a minimum of one opportunity for a formal PEB to fulfill the statutory requirement of Section 1214 of reference (b) for a full and fair hearing when requested by a Service member being separated or retired for physical disability under Chapter 61 of reference (b). The Service members declination of a formal PEB will be documented by the Physical Evaluation Board Liaison Officer (PEBLO) counselor. Appearance before a formal PEB may be in person, through a designated representative, or via video teleconferencing media.

...

E4. ENCLOSURE 4
GUIDELINES REGARDING MEDICAL CONDITIONS AND PHYSICAL
DEFECTS THAT ARE CAUSE FOR REFERRAL INTO THE DISABILITY
EVALUATION SYSTEM

E4.1. GENERAL

E4.1.1. This enclosure provides a listing, mainly by body system, of medical conditions and physical defects which are cause for referral into the Disability Evaluation System (DES).

E4.1.1.1. This listing is not all inclusive.

E4.1.1.2. A service member who has one or more of the listed conditions or physical defects is not automatically unfit and therefore may not qualify for separation or retirement for disability.

E4.1.2. Individual Secretaries of the Military Departments may, consistent with this Instruction, modify these guidelines to fit their particular needs. ...

...

E4.2. MUSCULOSKELETAL SYSTEM

E4.2.1. Upper Extremity.

E4.2.2. Lower Extremity.

E4.2.3. Inflammatory Condition.

E4.2.4. Prosthetic Replacement.

E4.2.5. Muscles.

E4.2.6. Tendon and/or Ligament Transplantation.

E4.2.7. Spine.

E4.2.8. Skull.

E4.2.9. Fibromyalgia.

E4.3. Organs of Special Senses

E4.3.1. Eyes.

E4.3.2. Ears and/or Hearing.

E4.4. SYSTEMIC DISEASES

E4.4.1. Definition.

E4.4.1.1. Infectious

E4.4.1.2. Arthritis

E4.4.1.3. Other Systemic Diseases

E4.5. RESPIRATORY SYSTEM

E4.5.1. Upper Airway.

E4.5.2. Lower Airway.

E4.6. CARDIOVASCULAR SYSTEM

E4.6.1. Heart.

E4.6.2. Vascular System

E4.6.3. Miscellaneous Conditions.

E4.6.4. Anticoagulant Therapy.

E4.7. GASTROINTESTINAL SYSTEM

E4.7.1. General.

E4.7.2. Inflammatory and/or Infectious Conditions.

E4.7.3. Obstructive Conditions

E4.7.4. Dysfunctional Conditions

E4.7.5. Abdominal Wall Defects.

E4.8. GENITOURINARY SYSTEM

E4.8.1. Urinary System.

E4.8.2. Female Genitourinary Conditions

E4.9. HEMIC AND LYMPHATIC SYSTEMS

E4.9.1. Anemia.

E4.9.2. Hemolytic Crises.

E4.9.3. Leukopenia.

E4.9.4. Polycythemia.

E4.9.5. Purpura or Bleeding disorders.

E4.9.6. Chronic Anticoagulation Therapy.

E4.9.7. Hypercoagulable states with thromboembolic disease.

E4.9.8. Indwelling Filter to prevent embolic phenomena.

E4.9.9. Leukemia, or history thereof.

E4.9.10. Lymphomas, or history thereof.

E4.10. SKIN AND CELLULAR TISSUES

E4.10.1. When conditions are severe, unresponsive to therapy, and interfere with the satisfactory performance of duty, wearing of the uniform, or using military equipment.

E4.10.2. Systemic Conditions ...

E4.10.3. Localized Conditions

E4.10.4. Infectious Conditions

E4.10.5. Other Chronic Skin Disorders.

E4.11. ENDOCRINE SYSTEM AND METABOLIC CONDITIONS

E4.11.1. General.

E4.11.2. Diabetes

E4.11.3. Acromegaly.

E4.11.4. Adrenal Hyper or Hypofunction.

E4.11.5. Diabetes Insipidus.

E4.11.6. Hyper or Hypothyroidism.

E4.11.7. Hyper or Hyoparathyroidism.

E4.11.8. Hyperinsulinism.

E4.11.9. Gout.

E4.11.10. Osteomalacia.

E4.11.11. Hypogammaglobulinemia.

E4.11.12. Hypercoaulable States.

E4.11.13. Heat Injury

E4.12. NERVOUS SYSTEM

E4.12.1. General.

E4.12.2. Neurogenic Muscular Atrophy

E4.12.3. Progressive Degenerative Disorders.

E4.12.4. Demyelinating Disorders.

E4.12.5. Residuals of Cerebrovascular Accidents.

E4.12.6. Residuals of Traumatic Brain Injury.

E4.12.7. Headaches.

E4.12.8. Seizure disorders.

E4.12.9. Narcolepsy.

E4.12.10. Sleep Apnea Syndrome

E4.12.11. Peripheral Nerve Dysfunctions

E4.12.12. Syringomyelia.

E4.12.13. General Neurological Disorders.

E4.13. PSYCHIATRIC DISORDERS

E4.13.1. General

E4.13.2. Disorders with Psychotic Features (Delusions or prominent Hallucinations).

E4.13.3. Affective Disorders (Mood Disorders). When the persistence or recurrence of symptoms requires extended or recurrent hospitalization, or the need for continuing psychiatric support.

E4.13.4. Anxiety, Somatoform Dissociative Disorders (Neurotic Disorders). When symptoms are persistent, recurrent, unresponsive to treatment, require continuing psychiatric support, and/or are severe enough to interfere with satisfactory duty performance.

E4.13.5. Organic Mental Disorders. Dementia or organic personality disorders that significantly impair duty performance.

E4.13.6. Eating Disorders. When unresponsive to a reasonable trial of therapy or interferes with the satisfactory performance of duty.

E4.14. NEOPLASMS

E4.14.1. Malignant Neoplasms

E4.14.2. Benign Neoplasms.

E4.15. GULF WAR CASES

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E5. ENCLOSURE 5
CONDITIONS AND CIRCUMSTANCES NOT CONSTITUTING A PHYSICAL DISABILITY

...

E5.1.3. SPECIFIC CONDITIONS AND OTHER CIRCUMSTANCES

E5.1.3.1. Enuresis

E5.1.3.2. Sleepwalking and/or Somnambulism

E5.1.3.3. Dyslexia and Other Learning Disorders

E5.1.3.4. Attention Deficit Hyperactivity Disorder

E5.1.3.5. Stammering or Stuttering

E5.1.3.6. Incapacitating fear of flying confirmed by a psychiatric evaluation.

E5.1.3.7. Airsickness, Motion, and/or Travel Sickness.

E5.1.3.8. Phobic fear of Air, Sea and Submarine Modes of Transportation

E5.1.3.9. Certain Mental Disorders including:

E5.1.3.9.1. Uncomplicated Alcoholism or other Substance Use Disorder

E5.1.3.9.2. Personality Disorders

E5.1.3.9.3. Mental Retardation

E5.1.3.9.4. Adjustment Disorders

E5.1.3.9.5. Impulse Control Disorders

E5.1.3.9.6. Sexual Gender and Identity Disorders, including Sexual Dysfunctions and Paraphilias

E5.1.3.9.7. Factitious Disorder

E5.1.3.10. Obesity.

E5.1.3.11. Overheight.

E5.1.3.12. Psuedofolliculitis barbae of the face and/or neck.

E5.1.3.13. Medical Contraindication to the Administration of Required Immunizations.

E5.1.3.14. Significant allergic reaction to stinging insect venom.

E5.1.3.15. Unsanitary habits including repeated venereal disease infections.

E5.1.3.16. Certain Anemias (in the absence of unfitting sequelae) including G6PD Deficiency, other inherited Anemia Trait, and Von Willebrands Disease.

E5.1.3.17. Allergy to Uniformed Clothing.

E5.1.3.18. Homosexuality