A longitudinal analysis of injuries resulting in physical disability

Abstract

U.S. Navy enlisted personnel hospitalized with primary diagnoses under the Accidents, Poisoning, and Violence (APV) category were followed to determine Physical Evaluation Board (PEB) decisions within six years of initial injury. The probability of disability separation, the severity of disability, and the time between injury and PEB were analyzed as functions of the type of injury and body part. Only 9.5% of APV hospitalizations resulted in a PEB, but 90% of the PEBs resulted in service separations. More than half of the disability separations involved fractures, dislocations, and sprains/strains to the extremities, especially the lower limbs. Nerve and spinal column injuries, although infrequent, had the highest probability of disability separation. The average time between injury and disability separation was 12.6 months with the more serious injuries (head, abdominal, and amputations) requiring the least average time (5–10 months) and the less serious injuries (fractures, dislocations, and sprains/strains) requiring the longest time (14–15 months). The PEB decisions showed that mobility was an important factor in fitness-for-duty decisions. It was recommended that decisionmaking guidelines, especially for less serious injuries, be improved to reduce the time between hospitalization and PEB disposition.