Mental health disorders in a cohort of U.S. Navy and Marine Corps personnel receiving waivers of medical accession standards

To assess risk of disability discharge in U.S. Navy and Marine Corps personnel receiving waivers of medical accession standards for mental health, we retrospectively identified a cohort of 22,960 waiver recipients from February 2001 to November 2005. Relative risk of Medical Evaluation Board (MEB) for any diagnosis was the same in the mental health waiver versus other waiver groups, but risk of MEB specifically for a mental health diagnosis was five times higher in the mental health waiver group. Also, risk of MEB for a musculoskeletal condition was significantly decreased in the mental health waiver group. Because of the high per-case compensation cost for mental health disability, this excess risk represents an estimated 32% higher disability compensation cost. We recommend further analysis of the waiver cohort to identify disqualifying conditions without excess disability risk. Targeting these conditions for policy changes could increase manpower without incurring long-term disability costs.