Temporal changes in U.S. Army disability rates, benefits and reasons for discharge from 1980 to 2005

Objective: Disability is a growing problem among U.S. military and civilian populations. We evaluated the relative contribution of changes in the Army's demographic composition to observed increases in disability discharges and compensation patterns. Methods: Time-series and logistic regression models were used to study 108,617 active-duty Army Soldiers discharged with permanent disabilities between 1980 and 2005. Overall disability rates and disability disposition compensation patterns were evaluated. Disposition compensation is based upon both the proportion of the disabling condition resulting from, or aggravated by, active-duty military service, and military tenure. Results: While the number of Soldiers discharged from the Army declined over the study period, the rate of permanent disabilities increased. Factors associated with disability discharge include female gender, minority race, younger age, and shorter tenure (Time Trend=-0.008, -0.003, -0.003, -0.022, respectively). Most prevalent causes of disability were musculoskeletal (70%), neurological (6%), mental health (5%), cardiovascular (4%), and respiratory conditions (4%). Factors associated with receipt of greater benefits include older age (OR range 1.10-2.18), Hispanic ethnicity (OR=1.22), having completed some college education (OR=1.27), median intelligence (1.08), higher-rank (OR range 1.51-2.38), and Soldiers with longer tenure (OR=1.25). Risk factors for receiving fewer benefits include male gender (OR=0.90), African-American race (OR=0.91), unmarried (OR range=0.81-0.95), and more recent disability discharge date (OR=0.94). Soldiers discharged with musculoskeletal and mental health disorders also received fewer benefits, whereas Soldiers with cardiovascular and neurological conditions received more benefits (OR=0.85, 0.22, 2.06, 1.32, respectively). Conclusions: Demographic changes in the Army may partially explain patterns of disability discharge and compensation.