Impact of Illness per ICD-9 Classification on Progression to Physical Evaluation Board for U.S. Marines Placed on Limited Duty Status 2006–2010

Abstract

Mission readiness is of paramount importance to Marine Corps commanders. Personnel medically unable to perform at full capacity negatively affect a unit's readiness and ability to accomplish mission objectives. A retrospective cohort study was designed to evaluate the impact of diseases and conditions per International Statistical Classification of Diseases and Related Health Problems, Revision 9 (ICD-9) classification of primary diagnosis on likelihood of progressing to Physical Evaluation Board (PEB) for U.S. Marines placed on Limited Duty. A total of 30,937 records belonging to 19,042 unique individuals were identified in the Medical Board Online Tri-Service Tracking System database over the study surveillance period. Approximately half (9,133) of all Marines placed on Limited Duty were eventually referred to PEB. After multivariate adjustment Marines with a primary ICD-9 diagnosis indicating a blood disorder (OR = 4.1, 95% CI 2.1-8.1) or nervous system disorder (OR = 3.3, 95% CI 2.8- 3.8) were at greater risk of progressing to PEB as compared to the lowest risk group, Marines with an orthopedic diagnosis. Occupational category, rank grouping, race/ethnicity, and ICD-9 category had statistically significant impacts of varying magnitude on the risk of progressing to PEB; no significant difference was found for sex.