Physical Evaluation Board IDES Beneficiary Rep

Hire Demands - Portsmouth, VA (30+ days ago)


Physical Evaluation Board Liaison Officer (PEBLO)

Naval Medical Center Portsmouth, VA (NMCP)

SECTION 1 – SCOPE

1.1. BACKGROUND

The contractor shall provide Physical Evaluation Board Liaison Officer (PEBLO) services for the Naval Medical Center Portsmouth, VA and its catchment area of responsibility (hereafter referred to as “the MTF”). The MTF provides medical support to approximately 27,800 active duty (AD) and reserve service members. The Physical Evaluation Board Liaison Officer (PEBLO) is a non-medical case management specialist who assists service members as their case moves through the Integrated Disability Evaluation System (IDES) or Legacy Disability Evaluation System (LDES). To achieve an informed and seamless transition for service members who are medically

separated or retired, the PEBLO’s responsibility continues until the service member attains veteran status and is transferred to Veterans Affairs (VA) support. The Medical Evaluation Board (MEB) and Physical Evaluation Board (PEB) programs are processes established under the IDES to delineate the operations, responsibilities, and composition of the boards convened on Active Duty Service Member (ADSM) and Reserve Component members with either temporary or permanent disabilities. The services required by this contract support these individuals

through the provision of PEBLO support services and personal affairs counseling. The service members now have the option now to choose the Legacy Disability Evaluation System process (LDES) or the Integrated Disability Evaluation System (IDES) to process their case as retirement/separation via LDES is faster, but without the Veterans Administration phase being completed. The purpose of the PEBLO is to administer program requirements and to

analyze and evaluate a variety of customers (military and Family members) as related to the retirement, transition, and Survivor Benefits Programs. Work is evaluated in terms of results achieved, soundness of overall approach, technical planning, and conformance with established procedures. The PEBLO is a liaison between the service member and a multi-disciplinary team (MDT) of physicians, primary care managers, other appropriate health careprofessionals, medical care case managers, non-medical case managers (e.g., Recovery Care Coordinator (RCC)),

patient administration personnel, the Physical Evaluation Board (PEB), the service member’s command, Personnel Support Detachment and Command Deployability Coordinators, and the Department of the Navy Safe Harbor liaison.

The work directly contributes to a “ready” military force. The PEBLO also provides assistance in obtaining financial, legal, and personal affairs counsel for the military members and family members. Problems resolved by the PEBLO affect the ability of individuals to receive timely and quality benefits and/or services as well as their future economic well-being. In all cases, the dignity of the service member will be given the highest regard, and all staff will adhere to the tenets of the Privacy Act and the Health Information Portability and Accountability Act and

safeguard Personally Identifiable Information (PII) and Protected Health Information (PHI).

1.2. SCOPE

The contractor shall provide counseling for military personnel being processed through the Integrated Disability Evaluation System (IDES) on their rights, benefits, privileges, and obligations. The Medical Evaluation Board Department processes an estimated 866 PEB cases per year, 2,271 limited duty/medical boards, 150 Temporary Disability Retirement List (TDRL) cases, and 2,500 cases for counseling to deliver findings to the service member.

SECTION 2 - TASKS

2.1. SPECIFIC DUTIES FOR PEBLO SERVICES: In addition to the tasks outlined in the base contract, see Section 2.1. and 2.5.9., the Contractor shall perform the following tasks:

2.1.1. The Contractor shall use Information Technology to document progress, concerns, or other issues relevant to the service member’s cases entering all mandatory data into Limited Duty (LIMDU) Sailor and Marine Readiness Tracker System (SMART), Veterans Tracking Application (VTA), DES User-Interface or other automated system as directed, ensuring accuracy and timeliness while monitoring the systems for possible cases that are nearing delinquency. The Contractor shall generate standard and customized management reports and charts tracking all

assigned cases, and analyze performance against established metrics related to processing performance.

2.1.2. A detailed account of other specific counseling tasks and related services are available in the Policy Guidance on Operating Procedures and Processes for the Disability Evaluation System (DES) Program at Navy Medical Treatment Facilities and Non-participating Medical Treatment Facilities, Enclosure 9, at http://www.med.navy.mil/policy guidance/Documents/NAVMED%20POLICY%2010-008.pdf and

http://www.woundedwarriorregiment.org/wwr/assets/File/PEBIDES/IDES_DTM-11-015.pdf

2.1.3. The Contractor shall explain the payment calculations for severance pay or retirement pay, or refer the service member to the appropriate Defense Finance and Accounting Service or finance representative.

2.1.4. The Contractor shall accurately monitor and track the metrics as listed below. Metrics to be reported include, number of days from referral to patient being sent to VA for evaluation, number of days from end of VA referral to mail into service headquarters, and total number of days before mailed to service headquarters (including VA).

2.1.5. The Contractor shall maintain a comprehensive knowledge of all policy, guidance, and program activities and maintain an effective working relationship with key NMCP program officials.

2.1.6. The Contractor shall coordinate and provide information to support the MTF in answering Congressional inquiries.

2.1.7. The Contractor shall coordinate IDES/LDES processing issues with other Department of Defense (DoD) and federal agencies (e.g., the Veteran’s Health Administration (VHA) and Veteran’s Benefits Administration (VBA)), to ensure transparency and clarity throughout the IDES process.

2.1.8. The Contractor shall assist, by request of the service member or Medical Boards Division supervisor, with the administrative completion of service member rebuttals and appeals; however, they are not legal advocates, and may not provide legal advice, legal counsel, or other assistance regarding substantive aspects of the rebuttal. The PEBLO shall ensure all service members see the Disability Evaluation System (DES) Attorney.

2.1.9. For all IDES cases, the Contractor shall educate the service member about the MEB and PEB process and results, and coordinate with the VA on all issues requiring the VA’s action.

2.1.10. The Contractor shall provide counseling for service members being processed through the IDES on their rights, benefits, privileges and obligations; coordinate evaluation appointments; assist in preparing appeals, rebuttals, and the assignment of service member’s legal counsel; and refer the service member to appropriate agencies to obtain counseling/guidance on benefits provided by the Department of Labor, Social Security Administration, Defense Finance and Accounting System (DFAS), and Department of Veterans Affairs (VA).

2.1.11. The Contractor shall assist in representation of the MTF and also liaison with Parent Commands, Medical Officers, Judge Advocate General (JAG) Officers, Nurse Case Managers, Personnel Support Detachment (PSD), Recovery Care Coordinators (RCCs), Federal Recovery Coordinators (FRCs), and VA to solve complex cases as they arise with the goal of meeting all DoD/VA prescribed timelines. The Contractor shall analyze, interpret, and apply new and established directives and instructions from Secretary of the Navy (SECNAV), BUMED, Chief, Bureau of Naval Personnel (BUPERS), Commandant of the Marine Corps (CMC), Headquarters Marine Corps (HQMC), JAG and VA, governing IDES/LDES, Temporary Disability Retirement List (TDRL), and LOD investigations. The Contractor shall maintain close liaison with the Centralized Physical Evaluation Board (CPEB), Military Service Coordinator (MSC), VA Claims Office, and NMCP physicians and support staff to discuss specific cases and to coordinate actions related to cases involving unusual circumstances of severely disabled service members or retirees.

2.1.12. The Contractor shall set and adjust priorities of work involving multi-sections/units for completion of Medical Boards. The Contractor’s workload may need to be prioritized/adjusted for the workday due to case files, requests from the physicians, requests from the service member, scheduling of appointments, etc.

2.1.13. The Contractor shall develop and maintain case files of required documentation from physicians, service member, Parent Command, other DOD and civilian hospitals, RCCs, FRCs and/or Personnel Support Detachment (PSD). Also, the Contractor shall verify that each case file is procedurally correct, complete, consistent, compliant, and authentic per MANMED Chapter 18, see Paragraph 2.2. The contractor shall provide the MSC a hard copy or electronic copy of the file when requested.

2.1.14. The Contractor shall prepare and conduct various briefings and training evolutions relevant to the IDES program to the service member and their family, MTF leadership, outlying Branch Medical Clinics, PSD, and Parent commands and other hospital clinical and administrative support staff. No travel is required to complete this task.

2.1.15. The Contractor shall collect demographic information on all personnel enrolled in the IDES/DES program and track the progress of the medical board throughout the facility.

2.1.16. The Contractor shall provide brochures (provided by the Government) and access to other organizational or online resources to the service member or the designated representative. The Contractor shall monitor scheduled appointments of PEB members, ensuring the no show rate is kept to a minimum, and shall arrange rescheduling with the MSC, when necessary.

2.1.17. The Contractor shall explain and assist in the processing of requests for formal boards and appeals.

2.1.18. The Contractor shall advise service members of available support provided by military, veteran, and national service organizations related to disability processing and transition services.

2.1.19. The Contractor shall refer the service member to the MSC to explain the potential VA benefits and VA specific appeal process, including the referral to a vocational rehabilitation and employment counselor. The Contractor shall refer the service member to the Social Security Administration (SSA) for information on benefits that the service member could receive while on active duty and after transition to veteran status.

2.1.20. The Contractor shall inform the service member of potential transition programs and benefits, or refer the service member to the appropriate base-level support agencies, including trained survivor benefit plan counselors and the transition assistance program staff.

2.1.21. The Contractor shall obtain the Line of duty investigation/Line of duty determination (LODI/LODD), when an injury is involved, from the service member’s command at the time of injury.

2.1.22. The Contractor shall ensure the service member is scheduled for all general and disability examinations required for their case through the designated MTF, contractor, Veterans Health Administration, or TRICARE provider. The Contractor shall ensure conflicts between DoD and VA examiner are resolved. The Contractor shall monitor the completion of examinations and resolve scheduling issues to ensure completeness of the case file. The Contractor shall electronically submit the case file to the VA and subsequently to the PEB for adjudication.

2.1.23. The Contractor shall provide the service member or his or her designated representative with a copy of the service member’s MEB results and the narrative summary; the informal PEB (IPEB) findings, ratings, and decision, and LOD determinations; and ensures medical records are available for review.

SECTION 3 – HOURS OF OPERATION

3.1. Services shall be performed at Naval Medical Center Portsmouth, VA. The work shall be performed between the hours of 0730 and 1630, Monday through Friday, excluding weekends, Federal holidays or when the Government facility is closed due to local or national emergencies, administrative closings, or similar Government directed facility closings.

SECTION 6 - QUALIFICATIONS

6.1. In addition to the qualifications outlined in Section 6.1 in the base contract, contract employees shall possess and maintain the following qualifications:

6.1.1. An Associate’s Degree in a business or health-related field. A Bachelor of Arts or Science with a major of study in hospital administration, public health administration, or related fields such as business or public administration with course work in health care administration is preferred.

6.1.2. Experience with the disability evaluation system is preferred.

6.1.3. One (1) year of experience using basic software applications, such as Microsoft Word, Microsoft Excel, and Microsoft Access.

Job Type: Full-time