WHAT TO KNOW IF YOU ARE ELIGIBLE FOR THE PHYSICAL DISABILITY BOARD OF REVIEW Who may apply? If you: • Were medically separated between September 11, 2001 and December 31, 2009 • Have a combined DoD awarded disability rating of 20% or less • Were not previously found eligible for a DoD disability retirement You are eligible to request a review of your disability ratings. Note: Former reserve members with greater than 20 years of Total Federal Military Service yet with fewer than 20 years of Active Duty and who meet the criteria listed above are also eligible. How to apply: A qualified service member, their surviving spouse, next of kin, or legal representative must submit a signed form DD 294 to the PDBR Central Intake Unit in San Antonio, TX. The form can be downloaded at: www.dtic.Mil/Whs/Directives/ Infomgt/Forms/Eforms/Dd0294.Pdf Marines medically separated as a result of a Department of the Navy Physical Evaluation Board determination since September 11, 2001 have the opportunity to have their disability ratings reviewed by the Physical Disability Board of Review (PDBR) to ensure fairness and accuracy. Upon application, the PDBR will examine each applicant’s medical separation, compare Department of Defense (DoD) and Department of Veterans Affairs (VA) ratings, and make a recommendation to the Secretary of the Navy that could result in a change in benefits. In more than half of the cases reviewed by the PDBR (as of April 2011), the applicant’s Service has agreed with the PDBR recommendation. If determined that you should have been medically retired, you will be placed on the Temporary / Permanent Disability Retired List (TDRL / PDRL). You should expect to see your retirement certificate / orders within 8–12 weeks. The same approval letter corrects your DD-214 to reflect disability retirement on a DD-215. What does this mean for you and your family if your application to the PDBR is successful? 1 You will receive (retroactive to the day of your original disability separation) monthly disability retirement pay. NOTE: By law, all previously awarded disability pay must be offset from these new retirement payments before you can actually begin receiving any new disability retired pay (this includes the original disability severance pay you may have been awarded from your military service department as well as any VA disability pay you’ve received – explicitly for the disability for which you are now being retired). 2 You (and your eligible dependents) will have all rights and privileges of a retired Veteran (e.g. commissary, exchange, space available recreation and travel, other benefits available via State and private sector organizations). 3 You are eligible to enroll in the Survivor’s Benefit Plan insurance for your dependents (you would be responsible for paying insurance premiums to bring your coverage up to date). 4 You would be eligible for DoD’s TRICARE health care coverage (retroactive to the day of your original disability separation). Coverage is extended to your eligible dependents as well. Previous medical expenditures incurred by you MAY BE retroactively reimbursed by TRICARE. Receiving Retroactive Reimbursement for Medical Expenses Once eligibility is established for TRICARE, contact the appropriate TRICARE Regional Office and request assistance through the claims division. A “reasonable time” exception (which is normally one year) will be made for retirees who are retroactively retired through the PDBR process. TRICARE requires copies of all medical expenses incurred by the member from the time he/she separated up to when the member was formally approved for retirement. Note: Significant collection and gathering of documents will need to take place on the part of the member prior to initiating these claims. Frequently Asked Questions How is the review conducted? The applicant will not appear in person, but may include any statements, briefs, medical records or other supporting documents with the application. After the document review is completed and final decision is made, each applicant will be notified of the decision and any further information regarding a change of rating. What CAN the PDBR do? The PDBR can recommend: 1. No change to the separation or the combined disability rating previously assigned. 2. Re-characterization of the separation to retirement for disability. 3. Modification of the combined disability rating previously assigned. The PDBR may not reduce the disability rating previously assigned. If the PDBR determines that a previous “fit” determination should be changed to “unfit,” the PDBR shall make the recommendation and assign a rating to that condition which will be combined with the other disability rating(s). The PDBR recommends, but who directs action on the final decision? The Secretary of the Navy shall accept or reject, in whole or in part, the recommendation of the PDBR within 45 days of PDBR recommendation. Notification of the decision shall be provided within 10 days. If accepted, notification shall include the effect (medical retirement or separation with severance pay) and effective date. In those cases where a record change is warranted resulting from an increase of a rating and/or retirement, the VA will be notified of the change. The Secretary will direct the Marine Corps to complete the actions approved. Who can I contact if I have questions on the PDBR process or my status? HQ Marine Corps Disability Section for Separations/Retirements (MMSR-4): 703-7849308/9309/9321 WWR Sergeant Merlin German Wounded Warrior Call Center: 1-877-487-6299 PDBR Intake Unit: 703-325-0874 / 0870 What if I do not receive my monthly retired paycheck or have other problems concerning my pay? Contact DFAS Retired Pay and Annuities at 1-800321-1080. How do I take advantage of/enroll in the benefits for which I’m now eligible? 1. Take your retirement certificate / orders or DD-215 to any DEERS / RAPID site to enroll and / or update DEERS information prior to enrolling in TRICARE and getting you blue retiree and dependant ID cards. 2. Obtain a DoD decal for access to any/all on base privileges at base security. 3. Complete DD form 2656 for DoD Survivor Benefit Plan (SBP). Note: Please read through the information carefully before electing or declining. If no election is made within 90 days of the receipt of the approval letter, DFAS will automatically provide coverage and reduce any retired pay to cover the premium costs. 4. Complete DD form 2860 for Combat Related Special Compensation (CRSC) (Marines with combat related injuries only). CRSC is retroactive to 1 January 08 for Marines who retired prior to 1 January 08. Visit the Wounded Warrior Regiment website for a fact sheet on CRSC. THE WOUNDED WARRIOR REGIMENT The Wounded Warrior Regiment (WWR) stood up in April 2007 and immediately began to assume responsibilities for non-medical wounded warrior care. The mission of the WWR is to provide and facilitate assistance to wounded, ill and injured (WII) Marines, sailors attached to or in direct support of Marine units, and their family members, throughout the phases of recovery. The Regimental Headquarters element, located in Quantico, Va., coordinates the operations of two Wounded Warrior Battalions located at Camp Pendleton, Calif., and Camp Lejeune, N.C. The Regimental Headquarters provides unity of command and unity of effort through a single Commander who provides guidance, direction, and oversight to the Marine Corps WII non-medical care process and ensures continuous improvements to care management and the seamless transition of recovering Marines. UNITED STATES MARINE CORPS WOUNDED WARRIOR REGIMENT ETIAM IN PUGNA “STILL IN THE FIGHT” www.woundedwarriorregiment.org • 877.487.6299 • 0413EXTLPDBR
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