Disabilities due to injury in the military

Introduction: Disability is a major health and economic issue in the Armed Forces associated with increased use of medical care, the loss of active duty time, and substantial compensation costs. Methods: The role of injuries in physical disability from the early 1980s to 1994 was assessed by reviewing administrative data from the U.S. Army Physical Disability Agency, the Naval Disability Evaluation Board, and the Air Force Physical Disability Division. Information on the number of disability cases reviewed in 1994, the leading causes of disability, and the disposition of each case were examined most closely. Also, information from the Department of Defense on the cost of compensating disability cases was reviewed. Results: Disability generally appears to be significant across the services, ranging from 10 to 30 events per 1000 personnel per year depending on the service. Evidence from the data reviewed indicates that 30% to 50% of disability cases may be due to injury. The leading conditions that bring about board reviews and lifetime compensation appear to be lower back and knee conditions, both commonly thought to be due to injuries. Total direct costs of compensation reached $1.5 billion for fiscal year 1990. Conclusions: While current disability data systems are maintained for administrative and not research purposes, the information available may be valuable for injury surveillance and research and suggests that injury-related disability is a major health and economic burden for the Armed Forces.