If an injury or illness may end your military career, you enter a process most service members have never heard of until it happens to them: the medical board. This guide explains the Integrated Disability Evaluation System (IDES) that ties the Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB) process to the VA, where your proposed VA rating comes from, and the difference between being separated with severance pay and being medically retired. It is strictly descriptive. VeteranHQ does not represent you before a board.
IDES: the DoD and VA working together
When a condition may make you unfit to serve, your case can enter IDES. In the VA's words: "If you're wounded, injured, or become ill while serving and can't perform your duties, your doctor will refer you to the Integrated Disability Evaluation System (IDES). Through this system, we work together with the Defense Department (DOD) to make disability evaluation seamless, simple, fast, and fair."
The point of IDES is that one set of exams and one rating serve both the DoD's fitness decision and your future VA benefits, instead of two disconnected processes.
Where the proposed VA rating comes from
This is the fact that surprises people: your VA rating can be set before you take off the uniform. The VA states: "If you're found to be medically unfit for duty, IDES will give you a proposed VA disability rating before you leave the service. You'll also be entitled to Veteran Readiness and Employment (VR&E) services."
A Military OneSource medical-discharge factsheet explains why the VA number can differ from the DoD number: "The VA disability rating that your service member receives can be higher than his or her DoD disability rating. The reason is that the VA disability rating addresses all referred and claimed service-connected conditions, not just those that make your service member unable to continue to serve in the military."
So two different ratings do two different jobs. The DoD rates only the conditions that make you unfit to serve. The VA rates all of your service-connected conditions. Our VA math guide and the combined rating calculator explain how multiple VA ratings combine into one number.
A required stop in the process
No source used here states, in its own words, what the Medical Evaluation Board and the Physical Evaluation Board each decide, so this guide does not define them. Ask your servicing board or your service's transition office for those definitions. What the VA does publish is one step you are entitled to:
| Stage | What happens |
|---|---|
| VR&E counselor meeting | A mandatory meeting when you reach the PEB at an IDES site |
The VR&E meeting is not optional. In the VA's words: "We have Vocational Rehabilitation Counselors (VRCs) assigned to military installations hosting an IDES site. When you're referred to the Physical Evaluation Board (PEB) at one of these sites, you'll have a mandatory meeting with a VRC." VR&E is the employment and retraining program; our VR&E vs Post-9/11 GI Bill guide explains it.
Because the Military OneSource factsheet used here is dated 2020, this guide uses it only for framing that the law still supports, and it does not state IDES processing-time goals, which no current source used here confirms.
Severance pay vs medical retirement
The board's disposition decides how you are compensated, and the dividing line is set by law. The two outcomes to understand are separation with severance pay and medical retirement.
The general outcomes, from the Military OneSource factsheet: "If the outcome of your service member's medical board is to separate with severance pay, to be transferred to the TDRL, or to be permanently retired, your family will receive compensation from the DoD." TDRL is the Temporary Disability Retired List.
The dividing line is in Title 10 of the U.S. Code. Medical retirement under 10 U.S.C. 1201 generally requires either that "the member has at least 20 years of service ..." or that "the disability is at least 30 percent under the standard schedule of rating disabilities in use by the Department of Veterans Affairs ..." Separation with severance pay under 10 U.S.C. 1203 generally applies where "the member has less than 20 years of service ..." and the disability "is less than 30 percent under the standard schedule of rating disabilities ..." In short: 30 percent or 20 years generally points to medical retirement; below both generally points to severance pay.
That distinction matters for money later. Military OneSource notes: "Generally, if your service member is eligible for disability retired pay from the DoD, the monthly amount he or she receives will be reduced by the amount of monthly VA disability compensation he or she receives. Depending on your service member's VA rating, however, he or she may be eligible for Concurrent Retirement and Disability Pay or Combat-Related Special Compensation." Our CRDP vs CRSC guide explains those two programs, and our guide on separation pay and VA offset recoupment explains how severance can be recouped from later VA compensation.
How this connects to your VA claim
IDES is one on-ramp to VA benefits, and it is not the only one. If you have a known separation date but are not going through a medical board, the pre-discharge BDD program is the standard path. In the VA's words: "If you have a service-connected condition, you can file a pre-discharge claim for disability benefits between 180 to 90 days before you leave the military. This claim process is called the Benefits Delivery at Discharge (BDD) program." Our BDD guide and the leaving-the-military checklist cover the transition paths.
What this does not mean
A medical board is not the same as a VA claim, and a DoD rating is not the same as a VA rating. The DoD rates only the conditions that make you unfit to serve; the VA rates all of your service-connected conditions, which is why the VA number can be higher. Reaching a board also does not by itself mean medical retirement: the 30-percent-or-20-years line in Title 10 separates retirement from severance pay, and a proposed rating is proposed, not final. Finally, being medically retired does not mean you automatically keep full retired pay alongside VA compensation; offsets apply unless CRDP or CRSC restores them.
Hypothetical example. A service member we will call Alex is referred to IDES after an injury. At the PEB stage he has his mandatory VR&E counselor meeting. The board finds him unfit, and because his condition rates above 30 percent, his disposition is medical retirement rather than severance. IDES gives him a proposed VA rating before separation that covers not only the unfitting condition but his other claimed service-connected conditions, so his VA rating comes out higher than his DoD rating. Later he looks into whether CRDP or CRSC applies to his retired pay. This shows how the stages connect. It is not a prediction about any real case, which the boards and the VA decide.
Where to go next
If you are separating, start with the leaving-the-military checklist and the BDD guide. To understand how multiple ratings combine into one VA number, see the VA math guide and the combined rating calculator. For the retired-pay side, our CRDP vs CRSC guide and separation-pay recoupment guide go deeper, and the VR&E vs GI Bill guide covers the retraining benefit IDES entitles you to. Look up any term in the glossary. VeteranHQ explains these programs and helps you organize records. We do not represent you before a medical board, and we do not file your claim.