Tightening medical requirements for recruits now could eventually save DoD billions, by reducing the number of enlisted service members who end up retiring or separating early due to medical issues, a new study has found.

The Rand Corp. looked at 10 policy changes DoD has made to its medical recruiting standards since 2002. Of those, seven policies tightened regulations and three loosened them. Some were minor, such as a 2005 change requiring recruits to show more flexibility and bend their knee to 110 degrees, instead of the previous 90 degrees. Some policy changes were broader, such as no longer allowing recruits with a current case of psoriasis to enlist.

Rand then looked at the entire pool of enlisted first-time recruits from each service from 2002 to 2012. Rand tracked how many of those service members medically separated or were medically retired over the next eight years, looking for troops whose records indicated a medical conditions affected by one of the 10 policy changes. It then evaluated whether those separations increased or fell for recruiting classes who enlisted after a change was implemented.

“We found a reasonable enough change that we could conclude that this was different,” and that tightening policies had reduced the number of separations and retirements, said Kathryn Edwards, an associate economist at Rand.

For DoD, that could mean a huge cost savings.

When an enlisted service member is medically separated with a disability rating of less than 30 percent, they are eligible for a one-time severance payment and 180 days of continued health care benefits. The amount of severance pay depends on years of service.

Service members with a disability rating of 30 percent or more can be medically retired, with greater benefits than those who are medically separated. Such troops can qualify for a monthly cash payout from DoD, based on the number of completed years of service or on a disability rating that lasts through death, Rand reported.

For example, Rand concluded that for every 10,000 recruits, the stricter knee policy was connected to seven fewer medical retirements or separations, said Heather Krull, a senior economist at Rand.

That equals a cost savings of $4.3 million per 10,000 recruits, just from the knee policy change, Rand found.

In its review, Rand found that of the 1.7 million new recruits who enlisted from 2002 to 2012, about 4 percent were medically retired and about 2 percent were medically separated during their first 8 years of service.

However, Rand did not find that the three policies that were loosened had a significant impact on the number of service members separated for medical reasons.

Rand did not make any recommendations from the study and emphasized that the recruiting policies are among many factors — such as whether recruits join at a time of heavy deployment — that can impact the number of medical separations and retirements.

Also, if the military gets four years of service out of a recruit who ends up getting separated in their 5th or 6th year, that’s still valuable, Krull said. So that’s a consideration when considering what medical conditions might benefit from tighter policies.

“When are these conditions likely to manifest, is the military going to get some good, valuable years of service?" Krull said. “It’s a balancing act.”