Medical And Non-Medical Predictors Of Disability Discharge Disposition For Navy Personnel With A Back Problem: A Focus On Entitlement

Kilbourne, Brock; Chesson, Charles V.; Hilton, Susan

doi:10.1037/e536652006-001

Cited by 1 publication

(9 citation statements)

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“…In a recent analysis of U.S. Navy Physical Evaluation (PE) Board medical discharge dispositions (i.e., severance pay versus temporary disability retirement) for back-problem cases, Kilbourne, Chesson, and Hilton (1988) found that discharge dispositions were related to the severity of the back problem and the individual's length of service. The severity rule (i.e., a minimum of 30% level of disability) for awarding disability compensation was more determinant for individuals with less than twenty years of service, while the 20-year rule (i.e., a minimum of 20 years of service creditable for retirement) was more determinant for those with twenty years or more of service.…”

Section: Introductionmentioning

confidence: 99%

“…These findings were consistent with PE Board regulations 1204, SS 1206) and provided support for the argument that costs of entitlement should be considered in addition to medical and administrative costs when attempting to assess the total costs of medical problems of active duty, enlisted Navy personnel. The Kilbourne, et al (1988) study prompts several questions of interest.…”

Section: Introductionmentioning

confidence: 99%

“…The underlying question is: Do Navy PE Boards uniformly invoke the severity and twenty-year rules to determine disability compensation regardless of the type of medical problem? If so, then findings and implications of the Kilbourne, et al (1988) back problem study should replicate in an analysis based on a different type of medical problem. For such a replication, mental health problems might pose a tough-case test because mental health diagnoses are generally less reliable (Faust & Ziskin, 1988 is often more disagreement than agreement (Drake & Vaillant, 1985;Lieberman & Baker, 1985;Mellsop, Varghese, Joshua, & Hicks, 1982).…”

Section: Introductionmentioning

confidence: 99%

“…A second question of interest is prompted by the Kolb, et al (1982) Hence, three objectives defined the present study. One objective was to examine the extent to which the Kilbourne, et al (1988) be severe and chronic)). Also treated as ordinal variables, as in the Kilbourne, et al (1988) study, were medical discharge disposition (severance pay [a one-time benefit] versus temporary disability retirement [an extended benefit]), paygrade (El, E2-E4, E5-E6, and E7-E9), and length of service (less than 20 years of service versus 20 years or more of service).…”

Section: Introductionmentioning

confidence: 99%

“…One objective was to examine the extent to which the Kilbourne, et al (1988) be severe and chronic)). Also treated as ordinal variables, as in the Kilbourne, et al (1988) study, were medical discharge disposition (severance pay [a one-time benefit] versus temporary disability retirement [an extended benefit]), paygrade (El, E2-E4, E5-E6, and E7-E9), and length of service (less than 20 years of service versus 20 years or more of service). Two control variables--presence of secondary diagnosis (no versus yes) and admission history (first admission case versus multiple admission case)--were treated as categorical variables.…”

Section: Introductionmentioning

confidence: 99%

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Psychiatric And Non-Psychiatric Predictors Of Disability Discharge Disposition For Navy Personnel With A Mental Health Problem: A Replication And Extension

Kilbourne¹,

Hilton²,

Goodman³

1988

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Problem Kilbourne, Chesson, and Hilton (1988) found that Physical Evaluation (PE) Board determinations for back-problem cases were related to severity of the problem and length of service. An important question is whether Navy PE Boards uniformly invoke these same two criteria regardless of the type of medical problem. If so, those back-problem results should replicate in the analysis of a different type of medical problem. Objective The main purpose of this study was to examine the extent to which severity of mental health diagnosis (i.e., psychotic [functional and organic] versus nonpsychotic) and length of service predict medical discharge disposition (severance pay versus temporary disability retirement). There was also interest in examining the extent to which mental health diagnoses were consistent from time of hospitalization to time of last PE Board determination. Lastly, this study provided an opportunity to elaborate on the contribution of entitlement costs to the total costs of medical care. Approach The approach of this study was to analyze data from the Navy Enlisted Career/Medical History File regarding the type of medical disability discharge awarded by PE Boards to active duty, enlisted Navy personnel with a mental health problem, in relation to severity of diagnosis, length of service, paygrade, presence of a secondary diagnosis, and number of hospital admissions. The sample (N=1,485) consisted of all incidences of PE Board dispositions of either severance pay or temporary disability retirement between 1981 and 1984, inclusive, for active duty, enlisted Navy personnel who had been hospitalized with a mental health problem as the primary diagnosis. 0* Findings Findings indicated that severity of mental health diagnosis and length of For service significantly predicted medical discharge disability. Hence, results }I for mental health problems replicated results for back problems, wherein the 0 same two primary criteria (i.e., the severity rule and the 20-year service ion rule) considered by PE Boards significantl predicted medical discharge __i .;t, i t On/

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%