MOSMedical Retention Board

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MOS/Medical Retention Board And the Physical
Disability Evaluation System
SFC Patrick J Campbell AR-MEDCOM, G1 Soldier
Support Branch
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ACRONYMS
LOD Line of Duty MEB Medical Evaluation
Board PEB Physical Evaluation Board NDRPEB
Non Duty Related PEB PEBLO PEB Liaison
Officer PDA Physical Disability
Agency NARSUM Narrative Summary MEBC Med Eval
Board Clerk MEBT Med Eval Brd Technician DCCS
Dep Cdr Clinical Services
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• MOS/Medical Retention Board
• (MMRB)
• The MMRB is an administrative screening board
  conducted under the provisions of AR 600-60 at
  the RRC level, that determines whether Soldiers
  who meet medical retention standards but have
  permanent 3 or 4 physical profiles who can
  physically perform their primary military
  occupational specialty (branch/specialty code for
  officers) in a worldwide, field environment.
  Referral to a MEB/PEB1 is one of four actions
  the MMRB Convening Authority (MMRBCA) may direct.
  When the MMRBCA directs referral to a
  MEB/PEB/NDRPEB, conduct of the board is
  mandatory.
• 1 See AR 600-60, para 4-20b, for specific
  finding applicable to Reserve Component soldiers
  not on active duty of more than 30 days.

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Med Bdes Scrub for P3 and P4 Profiles Notifies
AR-MEDCOMs Surgeons Office
AR-MEDCOM Surgeons office prepares and sends
Notification of Disqualification and Election of
Options Letter
Solder responds back to ARMEDCOM with option
letter
MMRB
DISCHARGE (MEB/NDR Only)
RRC Conducts MMRB sends results to AR-MEDCOM
G-1or Surgeons Office
Med Bde sends option letter to AR-MEDCOM G-1
MEB/ NDR-PEB
Found FFD, soldier remains in MOS
Found FFD but must RECLASS
Found Med Disqualified, will be sent option
letter from Surgeons office
Probation for 3 months Return to MMRB
Request will be forwarded to G-1 IRD who will
cut discharge order Officer discharges will be
forwarded to USARC for final approval.
Findings sent to AR-MEDCOM G-1 RECLASS order cut
by IRD, G-1
MEB/NDR-PEB
DISCHARGE/RETIRE
Request MEB/NDR-PEB Bde and soldier prepare
Packet and send to AR-MEDCOM G-1
Request Discharge Letter and Supporting Docs sent
to AR-MEDCOM G-1, TTHS cuts discharge order
ARMEDCOM G-1 sends packet to appropriate site
Await results
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MMRB Membership With Vote
President Will be COL, may be a LTC frocked to
COL Medical Officer Field grade Med Corps Off in
Ready, Stand-by Reserve or in Active Status
Additional Members Commissioned Off members
will be Field Grade Warrant Off at least 1
member will be a CW3-CW5 and senior to WO being
boarded. Remaining 2 will either be WO or
FGO Enl/NCO 1 member will be a SGM (preferably
a CSM if available), remaining 2 members must be
in rank of MSG-SGM
NOTE If a female or minority soldier is
boarded, a female or minority board member will
be appointed upon written request
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MMRB Membership With Out Vote
Personnel Advisor will be a commissioned
officer, warrant off, senior personnel sergeant
or DA civilian (GS-7 or above) will advise MMRB
concerning policy and procedures, the soldiers
PMOS duties and common tasks related to the
performance of the soldiers PMOS duties in the a
field environment (DA Pam 611-21)
Board Recorder will be an enlisted soldier or
DA civilian They will coordinate with the units
and MSC/DRU/DRC G-1s to obtain the MMRB packets
and medical records and then provide them to the
medical officer for review and analysis (at least
14 days prior to the board). Recorders will
prepare the boardroom and MMRB worksheet for each
board member and schedule the order of Soldiers
appearances before the board.
NOTE Exception to Policy to AR 600-60, dtd 8 Aug
2005 Army Reserve Soldiers have the right to
waive their right to appear before the MMRB.
Applies To TPU, IMA, IRR and AGR soldiers. Must
be submitted in writing
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What the Soldier Can and Cannot Do While Pending
Medical Board Action

• Can
• Attend Annual Training at Commanders Discretion
• CONTINUE TO ATTEND BATTLE ASSSEMBLIES!!!

• Can Not
• Attend Service Schools or reenlist
• Cannot Deploy or PCS/Retire

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MOS/Medical Retention Board MMRB
DA Form 3349 w/ Cdrs Approval of Physical
Limitations
Meets Retention Standards
MMRB
Found Medically Unfit for Retention Refer to PDES
PROBATION (3 mo) Must return to MMRB
RECLASSIFY in another MOS/AOC
RETAIN in MOS/AOC Return to Duty
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RC Non-Duty Related PEB
DoD Directive 1332.18, as implemented by DoD
Instruction 1332.38, affords RC members pending
separation for medical disqualification
(separation for failure to meet medical retention
standards IAW AR 40-501) the right to be referred
to a PEB for solely a fitness determination.
Referral is not mandatory but upon the request of
the Soldier. These are cases of RC Active Status
Soldiers not on extended active duty whose
disqualifying medical impairments were incurred
outside of military service and involve no issue
of aggravation while in a duty status. (Thus,
there is no statutory entitlement to PDES
evaluation.) Heretofore, these soldiers were
separated based solely on not meeting medical
retention standards. Referral to the PEB allows
these Soldiers to have fitness determined under
the standards applied to Active Army Soldiers and
RC Soldiers with service-incurred conditions.
The USAR Regional Readiness Command or the ARNG
State Headquarters refers the case to the PEBnot
the MTF. (The RC soldier may be referred to the
MTF for conduct of a physical, but the MTF does
not conduct a NDR-PEB.)
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Line of Duty/AGR
USAR
Does Not Meet Retention Standards
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Fitness for Duty Medical Examination
Commanders may refer Soldiers to the MTF for a
medical examination under the provisions of AR
600-20, para 5-4, when they believe the Soldier
is unable to perform MOS or specialty code duties
due to a medical condition. This examination may
cause conduct of a MEB, which will be forwarded
to the PEB when it finds that the Soldiers
medical condition falls below medical retention
standards
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• Medical Evaluation Board
• (MEB)
• The Medical Treatment Facility (MTF) initiates a
  MEB under the provisions of AR 40-400, Chap 7,
  when a Soldier has received maximum benefit of
  medical care for a condition which may render the
  Soldier unfit for further military service. The
  MEB documents the Soldiers medical retention
  standards IAW MAR 40-501, Chap 3. If the Soldier
  does not meet medical standards, the MTF refers
  the case to the applicable PEB for a
  determination of fitness under the policies and
  procedures of DoDI 1332.38 and AR 635-40

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USAR
Line of Duty/AGR
Does Not Meet Retention Standards
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Requirements to go before a MEB

• APPROVED Line of Duty (AC/AGR/USAR)

NOTE Many AC soldier do not have APPROVED LODs
in their medical records. It is felt that since
they have appropriate documents to show injuries
(ie DD214 and medical documents) then a DA Form
2173 is not needed. This is not true. If you
know of a soldier that has been injured and who
DOES NOT have an approve LOD, the following
documents will help substantiate their
claim 1. Deployment Orders 2. DD 214 3.
Medical Documents from initial treatment
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Example of an Approved LOD Memorandum

• MEMORANDUM FOR Commander, 143rd Transportation
  Command, 2800 Dowden Road, Orlando, FL 32827
• SUBJECT Line of Duty Injury SPC Campbell,
  Patrick J., 123-45-6789
• While performing the 2-mile event on the
  semi-annual APFT, SPC Campbell fell on the tarmac
  and injured his knees. He was taken immediately
  to Orlando Naval Training Center for evaluation
  and released.
• Reviewed for Completeness IN THE LINE OF DUTY
• POC is SFC Patrick J Campbell, 727-563-3736
• BY AUTHORITY OF THE SECRETARY OF THE ARMY
• SIGNATURE BLOCK

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MEB Initiation
Medical Board Section receives notification
Soldier will be a board by 1. Fit for Duty
Request 2. MMRB 3. Doctor Notification
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Basic Steps to the MEB Process

• MEB Initiation
• Soldier Briefing Unit Notification
• Physical Exam
• Consults / Appointments
• NARSUM Appt
• Final Signatures on MEB
• PEBLO Counseling to Soldier
• MEB to the PEB
• PEB Results
• To the PDA

Potential Appeal
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Board process (continued)

• Soldier is telephonically contacted by the
  Medical Clerk to come the MTF to start his/her
  board.
• Soldier completes paperwork (2807 2808) and
  Information worksheet.

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Board process (continued)

• Soldier is given schedule of appointments
• - Briefing (by PEBLO)
• - Physical Examination
• - Eye Examination
• - Hearing Test
• - Dental Appointment
• - Board Doctor Appointment (NARSUM)
• May generate consult(s) to another clinic

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Board process (continued)

• Board Doctor receives all paperwork (to include
  any consults required).
• Doctor dictates NARSUM
• Transcription provides NARSUM draft to Medical
  Clerk
• Medical Clerk reviews/corrects NARSUM draft,
  prepares MEB coversheet and Profile
• Medical Clerk forwards final MEB to doctor for
  review and final signatures (2 are required)

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Board process (continued)

• Medical Clerk receives signed/completed board
  from the doctor and forwards to PEBLO.
• PEBLO reviews board for administrative accuracy
  then forwards to DCCS (or designee).
• DCCS reviews for medical accuracy, signs board
  and returns to PEBLO.

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Board process (continued)

• PEBLO contacts soldier to review board.
• Soldier signs board.
• Board is forwarded to PEB for adjudication.
• PEB returns finding to PEBLO (via FAX)
• PEBLO contacts soldier to review findings
• Soldier signs findings
• Soldier is entitled to review time and appeal
  process.

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Board process (continued)

• Signed findings are forward (via FAX) to PEB for
  further processing (to USAPDA)
• If fit DA Letter of Fitness is forwarded to MEB
  office.
• If unfit DA places soldier in TRANSPROC system
  for separation/retirement.
• Unit Commander determines specific
  separation/retirement date (90 day window)

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• Physical Evaluation Board
• (PEB)
• The Physical Evaluation Board (PEB) makes a
  determination of physical unfitness and is
  required by law to rate the disability using the
  Department of Veterans Affairs Schedule for
  Rating Disabilities. DoD Instruction 1332.39 and
  AR 635-40, Appendix B, modify those provisions of
  the rating schedule inapplicable to the military
  and clarify rating guidance for specific
  conditions. Ratings can range from 0 to 100
  percent rising in increments of 10.

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• PEB Liaison Officer
• The individual responsible for counseling
  Soldiers referred into the PDES with a MEB is the
  MTF Physical Evaluation Board Liaison Officer
  (PEBLO). The PEBLO counsels the Soldier on
  MEB/PEB findings and related rights and benefits.
  If the MTF determines that the Soldiers is not
  mentally competent, the PEBLO counsels the
  designated next of kin.

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COMPLETED PEB PACKET

• MEB Packet
• Personnel Data
• Health Record

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• PEB Composition
• PEBs normally consist of a three-member board
  composed of a mixture of military and civilian
  personnel. The President is normally a colonel,
  but may be a GS-13 Civilian Adjudication Officer.
  The Personnel Management Officer (PMO) may be a
  field grade officer or a GS-13 Civilian
  Adjudication Officer. The physician may be a
  civilian or military. PEB members will be
  experienced officers who are thoroughly familiar
  with board procedures. When an RC Soldier
  appears before the board, one member must be from
  the Reserve Components.

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PEB Findings

• Fit
• Unfit
• Disability
• With or Without Severance

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• PEB Dispositions
• Fit For Duty
• The Soldier is judged to be fit when he can
  reasonably perform the duties of his/her grade
  and Military Occupational Specialty (or branch
  for officers)

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Existed Prior to Service (EPTS)

• According to acceptable medical principles,
  certain abnormalities and residual conditions
  exist that, when discovered, lead to the
  conclusion that they must have existed or have
  started before the Soldier entered military
  service. This results in the Soldier being
  separated with out benefits.
• Separation is given without Disability Benefits
  (monetary or medical)
• 8 Year Rule Exception
• LIMITED BENEFITS ARE GIVEN THROUGH INVOLUNTARY
  SEPARATION

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• Separation without benefits
• Separation without benefits occurs if the
  unfitting disability existed prior to service,
  was not permanently aggravated by military
  service and the member has less than 8 years of
  Active Duty (active duty days) or the disability
  was incurred while the Soldier was absent without
  leave or while engaging in an act of misconduct
  or willful negligence.

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• Separation with severance pay
• Separation with disability severance pay occurs
  if the Soldier is found unfit, has less than 20
  years of service as computed under 10 USC 1208,
  and has a disability rating of less than 30.
• Severance Formula
• Same for 0-20
• 2 x Yrs (up to 12) x Base Pay
• Example 6 Years 10 Months Active Service Would
  Be
• 2 X 7 X Base Pay
• Medical benefits for 6 Months

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• When the PEB determines UNFIT for DUTY, they also
  determine the of unfitness.
• ---- Existed Prior to Service (EPTS)
• 0 - 20 Severance Pay Calculation
• 30 or ? Medical Retirement

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• Temporary Retirement
• Temporary disability retirements occurs if the
  Soldier is found unfit and entitled to permanent
  disability retirement except that the disability
  is not stable for rating purposes. Stable for
  rating purposes refers to whether the condition
  will change within the next five years so as to
  warrant a different disability rating. However,
  stability does not include latent impairment
  what might happen in the future.

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Periodic Medical Re-Examination and Tenure
When placed on the Temporary Disability
Retirement List (TDRL), the law requires the
member to undergo a periodic medical
reexamination within 18 months at a minimum
followed by PEB evaluation. The Soldier may be
retained on the TDRL or a final determination may
be made. While the law provides for a maximum
tenure of 5 years on the TDRL, there is no
entitlement to be retained for the entire period.
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• Permanent Retirement
• Permanent disability retirement occurs if the
  Soldier is found unfit, the disability is
  determined permanent and stable and rated at a
  minimum of 30, or the Soldier has 20 years of
  service as computed under 10 USC 1208. (For
  Reserve Component Soldiers, this means at least
  7200 points)

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Differences BetweenPDES and DVA

• While both the Army and the Department of
  Veterans Affairs (DVA) use the Department of
  Veterans Affairs Schedule for Rating
  Disabilities, not all the general policy
  provisions set forth in the Rating Schedule apply
  to the military. Consequently, disability
  ratings may vary between the two. The Army rates
  only conditions determined to be physically
  unfitting, compensating for loss of a military
  career. The DVA may rate any service-connected
  impairment, thus compensating for loss of
  civilian employability. Another difference is
  the term of the rating. The Army's ratings are
  permanent upon final disposition. DVA ratings
  may fluctuate with time, depending upon the
  progress of the condition. Further, the Army's
  disability compensation is affected by years of
  service and basic pay while VA compensation is a
  flat amount based upon the percentage rating
  received.

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AR 40-501 Standards of Medical Fitness AR
600-60 Physical Performance Evaluation
System AR 635-40 Physical Evaluation for
Retention, Retirement, or Separation http//louis
villelaw.com/federal/physical_disability_sep_1.htm
http//www.louisvillelaw.com/federal/physical_di
sability_sep_2.htm http//www.louisvillelaw.com/f
ederal/physical_disability_sep_3.htm https//www.
hrc.army.mil/site/Active/TAGD/CMAOC/CACLOCATOR/CAC
LOCATORINDEX.htm
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QUESTIONS?