Disability Evaluation for
Retention, Retirement, or
Department of the Army
Disability Evaluation for Retention,
Retirement, or Separation This major revision, dated 19 January 2017—
Changes the title of the regulation from Physical Evaluation for
Retention, Retirement, or Separation to Disability Evaluation for Retention,
Retirement, or Separation (cover).
Designates the Deputy Chief of Staff, G–1 as the lead for the
Army Disability Evaluation System (para 2–1). o Adds policy and process for
the Military Occupational Specialty Administrative Retention Review (chap 3).
Addresses the eligibility of Soldiers pending or undergoing
Disability Evaluation System evaluation or disposition to opt for retirement
under the Temporary Early Retirement Authority (para 4–4c).
Incorporates Army Directive 2012–22 as modified by DODI 1332.18
(paras 4–10 and 4–20).
Addresses final disposition of Soldiers having an unfit finding
with 18 but less than 20 years active Service (para 4– 29).
Establishes policy for the Reserve Component non-duty related
process (para 4–34).
Establishes policy in support of the Department of Defense
mandated Expedited Disability Evaluation System (para 4–35).
Revises policy for physical evaluation board fitness
determinations to require a finding of unfit when the Soldier’s medical
condition causes the Soldier to be unavailable for worldwide deployment (para
Designates the Deputy Chief of Staff, G–1 as the disapproval
authority for continuation requests from Soldiers tracked by the Army Wounded
Warrior Program (para 6–4).
Revises policy and process to implement DODI 1332.18; DODM
1332.18, Volumes 1 through 3; and Department of Defense Memorandum, Personnel
and Readiness, dated 6 January 2009 (throughout).
of the Army Washington, DC
Disability Evaluation for Retention, Retirement, or
and implements the revisions to the deter- higher
headquarters to the policy propomination prescribed by Army Directive nent.
Refer to AR 25–30 for specific guid-
regulation applies to Army internal control process. This
the Regular Army, the Army National regulation contains internal control
proviGuard/Army National Guard of the United sions in accordance with AR 11–2
and idenStates, and the U.S. Army Reserve, unless tifies key internal controls
that must be otherwise stated. During mobilization, evaluated (see appendix B).
chapters and policies contained in
ulation may be modified by the proponent. Supplementation. Supplementation
of this regulation and establishment of comProponent and exception
authority. mand and local forms are prohibited with-
The proponent of this regulation is the Dep- out prior
approval from the Deputy Chief of uty Chief of Staff, G–1. The proponent has
Staff, G–1 (DAPE–MP), 300 Army Penta-
publication is a major revi- the authority to approve exceptions or waivers to
this regulation that are consistent gon, Washington, DC
sion. with controlling law and regulations.
improvements. Users are
regulation prescribes proponent may delegate this approval au- invited to send
comments or suggested im-provements on DA Form 2028 (Recom-
Army policy and responsibilities for
the thority, in writing, to a division chief within mended Changes to Publications
disability evaluation and disposition
of Sol- the proponent agency or its direct reporting Forms) directly
to Deputy Chief of Staff,
diers who may be unfit to perform
their mil- unit or field operating agency, in the grade G–1,
(DAPE–MP), 300 Army Pentagon,
itary duties due to physical
disability. As of colonel or the civilian equivalent. (This Washington,
such, this regulation implements the
re- includes delegation to the Commanding
quirements of Title 10,
United States Code, General, U.S. Army Physical Disability Distribution. This
publication is availa-
DODI 1332.18, DODM Agency). Activities may request a waiver to ble in
electronic media only and is intended
1332.18 (Volumes 1 through
3), and DOD this regulation by providing justification for command level A for
the Regular Army,
policy memorandums to
these issuances; that includes a full analysis of the expected the Army
National Guard/Army National
and Army Directive 2012–22
as modified benefits and must include formal review by Guard of the United
States, and the U.S.
by DODI 1332.18. This regulation
incorpo- the activity’s senior legal officer. All Army Reserve.
rates the policy formerly prescribed
by AR waiver requests will be endorsed by the
600–60 for the administrative
determina- commander or senior leader of the request-
tion of a Soldier’s medical
deployability ing activity and forwarded through their
(Listed by paragraph and page number)
Introduction, page 1 Purpose • 1–1, page 1
References • 1–2, page 1
Explanation of abbreviations and terms • 1–3, page 1
Responsibilities • 1–4, page 1
Chief, National Guard Bureau • 2–1, page 1
Deputy Chief of Staff, G–1 • 2–2, page 1
regulation supersedes AR 635–40, dated 20 March 2012; AR 600–60, dated 28
February 2008; and Army Directive 2012–22, dated 9 October 2012.
635–40 • 19 January 2017 i
Chief, Army Reserve • 2–3, page 2
The Surgeon General • 2–4, page 2
The Judge Advocate General • 2–5, page 2
Senior and unit commanders • 2–6, page 3
Soldier • 2–7, page 4
Referral • 3–2, page 4
Ineligible for referral • 3–3, page 5
Status of Soldier during evaluation • 3–4, page 5
Outcomes of evaluation • 3–5, page 5
Disability Evaluation System Overview, page 6
Scope of the Disability Evaluation System • 4–1, page 6
Applicability • 4–2, page 7
Soldiers absent without leave,
undergoing or pending adverse actions or involuntary administrative separation,
or with prognosis of imminent death • 4–3, page 7
Waiver of Disability Evaluation System • 4–4, page 9
Additional matters concerning legal representation of
Soldiers • 4–5, page 9
The Reserve Component Medical Evaluation Board Tracking
Office • 4–6, page 10
Evaluation Board, page 10 Policy
• 4–7, page 10
Status of Soldiers undergoing disability evaluation • 4–8,
Disenrollment from the Disability
Evaluation System as a result of certain adverse circumstances or actions • 4–
9, page 11
Preparation for the Medical Evaluation Board • 4–10,
Appointment of the Medical Evaluation Board • 4–11,
page 12 Medical Board
proceedings • 4–12, page 12
Soldier’s opportunities for further review • 4–13,
page 14 Impartial
medical review • 4–14, page 14
Medical Evaluation Board rebuttal • 4–15, page 15
Record of Medical Evaluation Board proceedings • 4–16,
Training and education for the referral and Medical
Evaluation Board phases • 4–17, page 15
Legacy procedures • 4–18, page 16
Evaluation Board, page 16 Policy
• 4–19, page 16
Appointment of physical evaluation boards • 4–20, page
Composition of informal and formal physical
evaluation boards • 4–21, page 16
The informal physical evaluation board process • 4–22, page 17
Eligibility for a formal physical evaluation board •
4–23, page 19 Formal
physical evaluation board process • 4–24, page 19
and quality assurance review by the U.S. Army Physical Disability Agency •
4–25, page 22 Appellate
review by the Army Physical Disability Appeal Board • 4–26, page 24 Final disposition by U.S. Army
Physical Disability Agency • 4–27, page 25
Final decision authority for unfit findings on certain
general and medical corps officers • 4–28, page 26
Final disposition for unfit Soldiers on active duty with 18
but less than 20 years active Service • 4–29, page 26
ii 40 • 19
Grade on retirement or separation for physical
disability • 4–30, page 27 Transition
benefits and pre-separation counseling • 4–31, page 27
Procedures for cases referred under the legacy process •
4–32, page 28
Temporary disability retired list • 4–33, page 28
Reserve Component non-duty related process • 4–34, page
Expedited Disability Evaluation System processing • 4–35,
for Determining Fitness and Permanence and Stability of Unfitting Conditions,
page 34 Standard for
unfitness due to disability • 5–1, page 34
Duties of office, grade, rank, or rating • 5–2, page 34
General criteria for making unfitness determinations •
5–3, page 34
Reasonable performance of duties • 5–4, page 34
Presumption of fitness • 5–5, page 35
Evidentiary standards for determining unfitness because of
physical disability • 5–6, page 36
Standards for determining permanence and stability for
permanent or temporary retirement • 5–7, page 36
for Determining the Compensability of Unfitting Conditions, page 37
Applicability of 10 United States Code 1201 through 10
United States Code 1203 • 5–8, page 37
Compensable criteria under 10 United States Code
1201 through 10 United States Code 1203 • 5–9, page 37 On active duty for more than 30
days • 5–10, page 37
Presumption of sound condition for
Soldiers on orders to active duty specifying a period of more than 30 days • 5–
11, page 37
Applicability of 10 United States Code 1204 through 10
United States Code 1206 • 5–12, page 38
Compensable criteria under 10 United States Code 1204
through 10 United States Code 1206 • 5–13, page 38 Impairments incurred during
prior service • 5–14, page 39
10 United States Code 1207a and pre-existing conditions •
5–15, page 39
of Section 1206a Title 10 United States Code on Title 10 United States Code
Section 1207a • 5–16, page 39
Other matters related to pre-existing disability • 5–17, page 39 Failure to comply with
prescribed treatment • 5–18, page 40
resulting from non-approved elective surgery or treatment • 5–19, page 40 Temporary disability retired
list determinations • 5–20, page 40
The rating of compensable disabilities • 5–21, page 41
Disability incurred during excess leave for review
of court-martial proceedings • 5–22, page 41 Line of duty requirements for disability cases •
5–23, page 41
for Administrative Determinations, page 42
Determinations for purposes of federal civil service
employment • 5–24, page 42 Determinations
for federal tax benefits • 5–25, page 43
Reserve Component Soldiers who are dual status
technicians • 5–26, page 43
Determinations relating to disability severance pay • 5–27, page 43
General • 6–1, page 44
Duty statuses eligible for continuation on active duty and
continuation on active Reserve status • 6–2, page 44 Eligibility criteria for
requests to be considered (adjudicated) • 6–3, page 44
Approval and disapproval authority • 6–4, page 45
Decision criteria • 6–5, page 45
Length of continuation • 6–6, page 45
40 • 19 iii
Termination • 6–7, page 46
Medical re-evaluation • 6–8, page 46
Disposition at end of continuation period • 6–9, page 47
Internal Control Evaluation, page 54
iv 40 • 19
This regulation establishes the Army Disability Evaluation
System (DES) according to the provisions of Title10, United States Code,
Chapter 61 (10 USC Chapter 61) and DODD 1332.18. It sets forth policies,
responsibilities, and procedures that apply in determining whether a Soldier is
unfit because of physical disability to reasonably perform the duties of his or
her office, grade, rank, or rating. If a Soldier is found unfit because of
physical disability, this regulation provides for disposition of the Soldier
according to applicable laws and regulations. The objectives of this regulation
an effective and fit military organization with maximum use of available
benefits for eligible Soldiers whose military Service is terminated because of
a service-connected disability.
prompt disability processing while ensuring that the rights and interests of
the Government and the Soldier
the Military Occupational Specialty Administrative Retention Review (MAR2) as
an Army pre-DES eval-
uation process for Soldiers who require a P3 or P4 profile
for a medical condition that meets the medical retention standards of AR
40–501. Dispositions include retention in primary military occupational
specialty (PMOS), reclassification, and referral to the DES.
1–2. References See appendix
1–3. Explanation of abbreviations and terms See
Responsibilities are listed in chapter 2.
The Director, Army National Guard (DARNG), on behalf of the
CNGB, will ensure that eligible Soldiers of the Army National Guard of the
United States (ARNGUS) are referred for evaluation by the MAR2 and DES, as
applicable, in a timely manner, and in accordance with this regulation. This
includes ensuring that duty-related referrals for Army National Guard (ARNG)
Soldiers not in an active status are regulated through the Medical Evaluation
Board Tracking Office (MEBTO).
as the lead for the DES.
Army regulations to carry out the provisions of 10 USC Chapter 61, Department
of Defense (DOD) policy
for the DES, and Army policy for MAR2.
a quality assurance process to—
Ensure policies and procedures established by DOD and this
regulation are fairly and consistently implemented.
Establish procedures to ensure the accuracy and consistency of
medical evaluation board (MEB) and physical evaluation board (PEB)
determinations and decisions.
Establish procedures to monitor and sustain proper performance of
the duties of MEBs, PEBs, and physical evaluation board liaison officers
and provide resources to meet DES performance goals, without reducing Soldier’s
access to due process con-
sistent with DODM 1332.18, Volume 1.
Commanding General (CG), U.S. Army Human Resources Command (HRC) on behalf of
the DCS, G–1 will—
Implement policy and establish procedures for the transition of
Soldiers from active duty to separation or retirement for disability. The CG
will ensure that eligible Soldiers of the United States Individual Ready
Reserve (IRR) are referred for evaluation by MAR2 and DES, as applicable, in a
timely manner, and in accordance with the provisions of this regulation.
Manage the adjudication process for Soldiers of the Active Army
and U.S. Army Reserve (USAR) who are determined unfit and request to be
continued on active duty (COAD) or to be continued on active Reserve (COAR).
Manage the MAR2 process for Active Army and USAR Soldiers.
f. The CG, U.S. Army Physical Disability Agency
(USAPDA) on behalf of the CG, HRC, or the DCS, G–1, as appli-
cable at the time, will—
(1) Assist the DCS, G–1
in developing the policies, procedures, and programs of the DES.
(2) Develop training
programs, guidelines, and curricular for the MEB, PEB, and appellate review
phases of the DES.
(3) Manage and direct the
(4) Serve as appellate
authority for formal or informal PEB proceedings, except where such appeal is
reserved to higher authority.
(5) Make the final
decision for the Secretary of the Army (SECARMY) concerning a Soldier’s fitness
for duty for continued service (and associated adjudicative determinations
related to unfit findings), except when such decisions are reserved to higher
(6) Accomplish final
administrative actions, to include authorizing to the installation transition
center the Soldier’s disability retirement or separation and publishing the
disability orders on Soldiers of the Reserve Component (RC) who are not on
(7) Determine the
disability percentage rating for cases adjudicated under the legacy process.
(8) Coordinate, control,
and manage all members on the temporary disability retired list (TDRL).
(9) Publish and make
available standard informational publications regarding the DES in hardcopy and
electronic form to provide general and specific information on the MEB and PEB
processes. These publications will include the rights and responsibilities of
the Soldier while navigating through the DES. These publications will be made
available at the servicing military treatment facilities (MTFs), Offices of
Soldiers’ Counsel, and PEB regions.
The CAR will ensure eligible Soldiers of the USAR Ready
Reserve are referred for evaluation by MAR2 and DES, as applicable, in a timely
manner, and in accordance with this regulation.
in coordination with DCS, G–1 and USAPDA, policies governing the MEB process
for MTFs worldwide.
and interpret medical standards for Soldiers of all components.
that training and credentialing requirements are formalized and standardized
for the Army Medical Depart-
ment participants in the DES.
U.S. Army Medical Command (MEDCOM) on behalf of the TSG will—
Ensure all major MEDCOMs are responsible for the administration
of patients receiving care in MTFs under their jurisdiction.
Ensure that Army MTFs under their control fulfill their
responsibilities in connection with the DES, as outlined in this regulation.
Develop and execute agreements to support the disability process
of members who receive medical care from another military department, including
MTFs under the Defense Health Agency.
Establish procedures to ensure Servicemembers who are
hospitalized or receiving treatment at a U.S. Department of Veterans Affairs
(VA) or a non-Government facility are referred, processed, and counseled in a
manner similar to their peers.
Establish monitoring procedures to ensure MTF personnel
consistently use the approval authority signature date on the DA Form 3349
(Physical Profile) as the MEB referral date in the Veterans Tracking
e. The MTF commanders on behalf of the TSG will—
thorough and prompt evaluations for Soldiers in the DES process.
MEB proceedings referred to the PEB are complete, accurate, and fully
documented as outlined in this regulation.
Interpret laws and regulations governing the DES.
In coordination with the Staff Judge Advocate (SJA), MEDCOM
and the Director of the Office of Soldiers’ Counsel (OSC), MEDCOM, train and
provide sufficient appointed legal personnel, specifically Soldiers’ MEB
Counsel (SMEBC), Soldiers’ PEB counsel (SPEBC), and supporting paralegals to
represent Soldiers in the DES who request appointed counsel.
Establish standardized certification training programs and
curricula for OSC personnel, SJAs, and Department of the Army (DA) Civilian
attorneys within the Judge Advocate Legal Services, representing Soldiers
throughout the DES process.
Review requests by SJAs or DA Civilian attorneys who are not
currently assigned to an OSC to represent Soldiers
within the DES. Requests will be routed through the
Director of the OSC, MEDCOM and the SJA, MEDCOM, and forwarded to TJAG, Legal
Assistance Policy Division (DAJA–LA). Individual certification will be based
upon the counsel's training, experience, current duty position and
responsibilities, and on the particular circumstances of the Soldier's DES
case. TJAG, or the designee, has authority to approve individual certification
for non-OSC SJAs or DA Civilian attorneys.
a. The senior commander is
responsible for the successful completion of all aspects of the MEB process at
their installation. They are responsible for ensuring all subordinate
commanders are in compliance with the requirements and responsibilities
established by this regulation and all applicable DOD and Army directives on
DES. In coordination with the MTF commander and DES leaders, the senior
commander is responsible for issuing and enforcing local DES policy guidance,
procedures, timelines, staffing, and resourcing. To meet these
responsibilities, at a minimum, the senior commander will— (1) Be accountable
for all Soldiers in the DES assigned to the installation.
Ensure that unit commanders and first sergeants receive training
on all Integrated Disability Evaluation System (IDES) processes and systems,
including Medical Protection System and DA Pam 220–1, electronic profile
(e-Profile) (see AR 40–501), and electronic line of duty (LOD), and the
Commander’s IDES Dashboard.
Establish clear local guidance regarding all procedures and
standards established by this regulation.
Emphasize the importance and purpose of DA Form 7652 (Disability
Evaluation System (DES) Commander’s Performance and Functional Statement) and
the completion of LOD investigations in accordance with AR 600–8–4.
Create a common location for DES offices, co-locating both DOD
and VA assets when possible.
Provide borrowed military manpower via Soldiers Skill Set
Utilization Program to support surge requirements on the installation.
Ensure Soldiers and their families have access to the Soldier and
Family Assistance Centers, Transition Centers, and any other relevant services,
Ensure commanders verify that Soldiers attend all exit briefs as
required to ensure smooth handoff to VA.
Ensure permanent (P) and temporary (T) medical profiles
containing a numerical designator of 3 or 4 (hereafter referred to as a P3/P4
or T3/T4 profile) in one of the serial profile factors are reviewed according
to Army standards of AR 40–501.
the policy of AR 135–175, AR 135–178, AR 600–8–24, AR 635–200, and this
regulation is followed concerning the precedence of administrative separation
or disability evaluation when administrative separation action, or action under
the Uniform Code of Military Justice (UCMJ), is begun or approved before,
during, or after the Soldier is identified for or referred to the DES.
b. Unit commanders will—
Ensure medical profiles containing a P3/P4 or T3/T4 in one of the
serial profile factors are reviewed according to Army standards in AR 40–501.
Ensure Soldiers attend all required medical and administrative
appointments and exit briefings, and that Soldiers are in full compliance with
all requirements during the DES process.
Ensure Soldiers enroll and attend all Soldier for Life –
Transition Assistance Program events and meet all requirements of the Veterans
Opportunity to Work Act and Career Readiness Standards.
Provide escort for non-compliant Soldiers utilizing unit funds.
Coordinate and fund transportation to enable the Soldier to
report to scheduled appointments and to formal PEB (FPEB) hearings. This does
not apply to cases referred under the non-duty related process, unless the
Soldier is directed to a FPEB. Ensure Soldiers traveling to a FPEB have
sufficient time to arrive (more than one duty day) in advance of the scheduled
hearings to confer with appointed legal counsel.
Keep the PEBLO informed of all changes in Soldier’s personal
circumstances, to include command-approved leave (see para 4–7a),
temporary duty orders, initiation of or pending administrative separation
action or charges under the UCMJ.
Ensure all documentation required by the PEBLO is provided to
include required LOD determinations.
Attend or review the DES orientation briefing with the Soldier.
Provide a non-medical assessment by completing DA Form 7652.
access to IDES.
Soldiers enrolled in the IDES are extended on active duty, if needed and upon
the Soldier’s consent, to complete the DES process.
Soldiers who have completed IDES (have approved cases) start the transition
process within 7 workdays and begin transition leave or permissive temporary
duty, if authorized, not later than 45 days of the case being approved.
c. If the information about a
restricted report of sexual assault comes to the commander’s attention as a
result of a disclosure that is required for fitness of duty or disability
determination, the commander shall not report the matter to the U.S. Army
Criminal Investigation Command.
The Soldier will—
all scheduled appointments.
with providing required personnel and administrative data and documentation.
PEBLO and unit informed of all changes in personal circumstances, appointment
conflicts, and administrative
actions that may impact the completion of evaluation and/or
in the Soldier for Life – Transition Assistance Program upon referral to the
transition processing immediately upon notification that the case has been
approved with an unfit finding.
chapter implements and establishes policy for the MAR2. Soldiers must be of
sufficient medical fitness to satisfactorily perform their PMOS or area of
concentration (AOC), as well as those functional activities listed on the DA
Form 3349, which all Soldiers must perform regardless of PMOS or AOC. (All
functional activities listed on the DA Form 3349 must be marked “YES” for
Soldier to be eligible for referral to a MAR2). The MAR2 is an administrative
process for Soldiers who meet the medical retention standards of AR 40–501, but
who nonetheless may not be able to satisfactorily perform the duties of their
PMOS or AOC in a worldwide field or austere environment because of medical
limitations. The MAR2 process is used to determine whether a Soldier will be
retained in their PMOS or AOC or reclassified into another PMOS or AOC.
Soldiers who do not meet PMOS or AOC standards and who do not qualify for
reclassification will be referred into the DES.
DA Pam 635–40 for process procedures.
MAR2 review process replaces the Military Occupational Specialty Medical
Retention Board process.
a. Subject to the exclusions listed in paragraph
3–3, referral for MAR2 is required in the following circumstances:
The Soldier is issued a DA Form 3349 with a P3/P4 in at least one
of the profile serial factors for a medical condition(s) that meet the medical
retention standards of AR 40–501. Any DA Form 3349 generated for a USAR Soldier
in a drilling troop program unit or Active Guard Reserve (AGR) status must be
validated by the U.S. Army Reserve Command’s Medical Management Center
(AFRC–CIE) before their referral into MAR2.
When the MEB determines the Soldier meets medical retention
standards and returns the Soldier to duty with a P3 or P4 profile.
A Soldier previously evaluated by a MAR2 that resulted in
retention in their PMOS or reclassification to a new PMOS, or a Soldier who was
determined fit as the final outcome of PEB adjudication, when one of the
following events occurs:
Soldier receives additional functional limitations for the condition(s) that
initially generated the referral to MAR2 or processing through the DES.
Soldier receives a P3/P4 for a new condition(s) that meet medical retention
b. Soldiers previously retained
by MAR2 or the DES may be referred again to MAR2 for the same condition(s) with
no change in the profile status when there is evidence that the condition(s)
for which the Soldier was retained precludes the Soldier from performing their
duties in a satisfactory manner. Such referral must be recommended by the first
O–6 in the Soldier’s chain of command and occur no earlier than 120 days from
the Soldier’s previous evaluation. The Soldier must be referred to a MTF for an
updated profile if, at the time of the resubmission, the profile is older than
RC Soldiers not on active duty are referred to their
respective State or Regional Support Command Surgeon.
Soldiers in the following circumstances will not be
referred for MAR2:
Soldier is issued a DA Form 3349 confirming the Soldier is ineligible for a
MAR2 because they have a condition that does not meet medical retention
standards in accordance with AR 40–501 and/or prevents the Soldier from
performing all required functional activities. These Soldiers will generally be
processed through the DES. If the MEB, however, determines the Soldier meets
medical retention standards but requires a P3/P4 profile, the Soldier’s command
will refer the Soldier to MAR2.
Soldier’s request for regular retirement, non-regular retirement, or transfer
to the Retired Reserve has been ap-
officer is within 12 months of their mandatory retirement and/or removal date.
enlisted Soldier within 12 months of their retention control point (RCP) and
will be retirement eligible at RCP, or an RC enlisted Soldier within 12 months
of their mandatory removal date and will be eligible for a 20-year letter on
Soldier is within 90 days of their expiration term of service (ETS) and does
not have a remaining military service
Soldier is being processed for administrative separation pursuant to AR
135–175, AR 135–178, AR 600–8–24,
and AR 635–200.
Soldier failed to complete initial military training, advanced individual
training, or Basic Officer Leaders Course.
the failure is due to medical reasons, the Soldier will be referred to the DES.
the Soldier receives a P3 during training (to include for a condition for which
the Soldier was granted an accessions waiver) and the condition meets medical
retention standards, the Soldier will undergo MAR2 evaluation no later than six
months after reporting to their first duty assignment.
Soldier is serving on active duty as a retiree recall.
officer holds general officer rank. General officers will receive a retention
standards physical. If they meet med-
ical retention standards, their ability to deploy will be a
command determination without referral to MAR2. If the general officer does not
meet medical retention standards, the general officer will be referred to the
DES under the applicable DES process (duty-related or non-duty-related) (see
From the time a Soldier receives a P3/P4 profile until the
time the MAR2 process is completed (including a decision on any appeal), the
perform PMOS or AOC duties, to include duties in a field environment, within
the limitations of the profile.
eligible for awards and for promotion consideration, promotion selection, and
temporarily in a nondeployable status, but the commander may permit their
deployment after consulting with a
medical officer, the chain of
command, and the combatant command surgeon for the proposed theater of
operation. d. Is subject to disciplinary action.
ineligible for reassignment instructions or orders. If the Soldier has already
received reassignment orders prior to initiation of the MAR2 process, the
process must be completed and a final decision rendered before the Soldier
proceeds on assignment.
ineligible for reenlistment, permanent change of station, transfer within a
component or transfer between compo-
ineligible to be scheduled for or attend training for which the U.S. Army
Training and Doctrine Command is the
extend their enlistment to complete MAR2 evaluation if otherwise eligible for
such extension under the provi-
sions of AR 601–280.
Evaluation by MAR2 will result in one of the following
Retention in occupation. The Soldier meets PMOS or
AOC medical requirements of DA Pam 611–21 for their grade
and skill level or has been provided a proponent waiver of
Reclassification/branch transfer. The Soldier meets
PMOS or AOC medical requirements of DA Pam 611–21 for their grade and skill
level for a different PMOS or AOC and will be reclassified and/or transferred
into that PMOS and/or AOC.
Referral for disability evaluation. The Soldier does
not meet PMOS or AOC medical requirements and does not qualify for
reclassification and/or branch transfer into a different PMOS or AOC due to the
Soldier’s medical limitations (including anticipated progression of the medical
condition) or because manpower requirements do not support reclassification
and/or branch transfer. With referral for disability evaluation under the
duty-related process, completion of the MEB and PEB phases of the DES are
generally required for both Active Army and RC Soldiers. The MEB may only
return the Soldier to duty when the Soldier’s medical condition allows each of
the profile factors to contain a P1 or P2 in addition to finding that the
Soldier meets medical retention standards. With a MAR2 referral of an RC
Soldier to the medical disqualification process for non-duty related
condition(s), completion of a requested or otherwise required non-duty related
PEB is required unless the Soldier qualifies for and concurs with separation
due to medical disqualification or transfer to the Retired Reserve.
Public Law 110–181 defines the term, physical DES, in part,
as a system or process of the DOD for evaluating the nature and extent of
disabilities affecting members of the Armed Forces that is operated by the
Secretaries of the military departments and is comprised of MEBs, PEBs,
counseling of Soldiers, and mechanisms for the final disposition of disability
evaluations by appropriate personnel. (See the notes to 10 USC 1171 for the
Title XVI provisions.)
A Soldier may not be discharged or released from active duty
because of a disability until they have made a claim for compensation, pension,
or hospitalization with the VA or have signed a statement that their right to
make such a claim has been explained, or have refused to sign such a statement.
The objectives of the DES are to—
Maintain an effective and fit military organization with maximum
use of available manpower;
Provide benefits for eligible Soldiers whose military Service is
terminated because of a disability incurred in the LOD.
Provide prompt disability processing while ensuring that the
rights and interests of the Government and the Soldier are protected.
d. The DES consists of the three systems listed
below and as defined in the glossary. The policies and mandated pro-
cedures for these processes are set forth in this chapter.
See DA Pam 635–40 for additional procedures.
Legacy Disability Evaluation System. Under the legacy
system, for cases referred under the duty-related process, the PEB determines
fitness and determines the disability rating percentages using the Veteran’s
Administration Schedule for Rating Disabilities (VASRD). The legacy process
also includes the RC non-duty related referral process. No disability ratings
are assigned for non-duty related cases (see paragraph 4–18 and 4–32).
Integrated Disability Evaluation System. The IDES
A single set of disability medical examinations that may
assist the DES in identifying conditions that may render the Soldier unfit.
A single set of disability ratings provided by VA for use by
both departments. The DES applies these ratings to the conditions it
determines to be unfitting and compensable. The Soldier receives preliminary
ratings for their VA compensation before the Soldier is separated or retired
(3) Expedited Disability Evaluation
System. A voluntary process for Soldiers unfit for catastrophic injuries
or diseases in which USAPDA may permanently retire the Soldier for disability
without referral to the PEB based on the MTF’s medical narrative summary
e. The DES begins for a Soldier when either of the
events below occurs:
Soldier is issued a permanent profile approved in accordance with the
provisions of AR 40–501 and the profile contains a numerical designator of
P3/P4 in any of the serial profile factors for a condition that appears not to
meet medical retention standards in accordance with AR 40–501 (see glossary).
Within (but not later than) one year of diagnosis, the Soldier must be assigned
a P3/P4 profile to refer the Soldier to the DES. Any DA Form 3349 generated for
a USAR Soldier in a drilling Troop Program Unit or AGR status must be validated
by the U.S. Army Reserve Command’s Medical Management Center before their
referral into the DES.
Soldier is referred to the DES as the outcome of MAR2 evaluation.
f. The DES concludes for Soldiers as set forth
For Soldiers determined by the MEB to meet medical retention
standards and MAR2 did not refer the Soldier to the DES, the DES concludes the
date the MEB returned the Soldier to duty. (If referral to MEB resulted from
MAR2 evaluation, referral to the PEB may be mandatory (see para 3–5).)
For Soldiers referred to the PEB and determined fit, the DES
concludes as of the date of USAPDA’s memorandum approving the finding of fit.
For Soldiers referred to the DES under a Legacy Disability
Evaluation System (LDES) process and determined unfit, the DES concludes on the
date of the Soldier’s separation or retirement for disability.
For Soldiers referred to the DES under the IDES process and
determined unfit, the DES concludes on the date of the Soldier’s notification
of the VA’s benefits decision. However, the Soldier’s military status as a
member of the Active Army or RC, as applicable, ends on the date of the
Soldier’s disability separation or retirement.
Delaying DES processing or disposition is not authorized for
the purpose of increasing the length of time the Soldier remains on active duty
and receiving military benefits, allowing death in an active duty status, or
increasing a Soldier’s compensation for or otherwise related to disability
retirement or disability separation.
Information contained in a restricted report of sexual
assault that is necessary for a fitness for duty or disability determination
shall only be disclosed as necessary to the officials participating in the
processing of the board and shall be limited to that purpose. Receipt of
information from a restricted report by personnel involved in the processing of
a disability case who are not individuals that can take a restricted report in
accordance with DODI 6495.02 shall not cause a restricted report to be considered
unrestricted. All restricted reporting information remains confidential and
protected. Personnel who receive confidential information from a restricted
report for the purpose of disability processing, shall be subject to the same
requirements as healthcare personnel with regards to safeguarding personal
information and may be subject to disciplinary action if such information is
disclosed without authority.
a. The DES applies to Active Army, RC Soldiers,
recalled retirees, and cadets of the United States Military Academy.
The non-duty related process applies to RC Soldiers who are not
on active duty and who do not meet medical retention standards because of
non-duty related impairments.
RC Soldiers, who were called to active duty under the provisions
of 10 USC 12301 but then released from active duty by the 30th day due to the
identification of a pre-existing condition not aggravated by the current tour
of active duty, and which fails retention standards, will come under the applicable
DES process based on whether the pre-existing condition was previously incurred
in the LOD (duty-related process) or was a condition incurred when not in a
duty status (non-duty-related process).
RC Soldiers on active duty orders specifying a period of more
than 30 days will, with their consent, be kept on active duty for disability
evaluation processing until final disposition, subject to the circumstances set
forth in paragraph 4–2a(2).
The original orders issuing authority is responsible for
coordinating with MEDCOM to generate a 12301(h) order extending the RC Soldier
on active duty to complete the DES process.
The original orders issuing authority is responsible for
providing the funding for the 12301(h) order and any tem-porary duty travel for
DES required appointments.
The legacy process (see paras 4–18 and 4–32) may be used on
a case-by-case basis for any Soldier or member
eligible for IDES evaluation when circumstances exist that
the IDES process may have a detrimental impact on the disability process, the
Soldier, or the Army. The Soldier or command may request the LDES in lieu of
Reserve Officers' Training Corps cadets are not eligible for
processing through the DES, even if injured during train-
ing. Cadets who are in a RC Simultaneous Membership
Program are the exception, and are eligible for duty-related DES processing if
injured in training.
Provided the Soldier has no other conditions which are cause
for MEB referral, a Soldier with one or more congenital or developmental
defects not compensable under the VASRD will not be referred to the DES even
when these conditions require a P3/P4 profile or interfere with duty
The legacy process will be used for Army Veterans referred to
the DES by the Army Board for Correction of Military Records (see para 4–18).
Absent without leave. A Soldier who is absent without
leave is not eligible to be referred to or continue the MEB, PEB, or final
disposition phase of the DES. Once the Soldier is dropped from the rolls of the
Army, their case is terminated. If the Soldier returns to military control
before being dropped from the rolls of the Army, the Soldier’s DES processing
may resume. The NARSUM, or addendum to the NARSUM, as applicable, will reflect
the status of the medical evaluation at the time the Soldier went absent
without leave, and will address whether the Soldier incurred new medical
conditions or aggravated medical conditions during the absent without leave
period. If new or aggravated conditions exist, a formal LOD conducted in
accordance with AR 600–8–4 is required.
Reserve Component Soldiers with unexcused absences.
RC Soldiers who have nine or more unexcused absences from scheduled inactive
duty training (IDT) during a one year period will be considered unsatisfactory
participants. They will not be referred to or continue DES processing unless
the Soldier has a documented LOD medical condition which fails medical
retention standards. The condition must be the direct medical cause or a
significant contributing factor to the unexcused absences. Exceptions will be
for those RC Soldiers who have clear and incontrovertible evidence in the form
of a documented LOD or equivalent establishing a direct cause for their
absences, as determined by military medical authorities.
Action under the Uniform Code of Military Justice.
When Soldiers are under investigation or are charged with an
offense under the UCMJ that could result in a punitive
discharge (dismissal, dishonorable discharge, or bad conduct discharge), they
remain eligible to be referred to and complete the MEB phase of the DES.
Eligibility for the PEB occurs when one of the actions listed below occurs.
(The PEB or USAPDA, as applicable, will suspend adjudication or disposition
when UCMJ action is initiated during the PEB or USAPDA review phases. These
cases remain suspended until final UCMJ action is taken or one of the following
(1) The investigation
ends without charges.
(2) The officer
exercising proper court-martial jurisdiction dismisses the charges.
(3) An officer submits a
resignation for the good of the Service under the provisions of AR 600–8–24
(this includes when the resignation is in lieu of referral to a General
(4) The officer
exercising proper court-martial jurisdiction refers the charge for trial by
conviction does not include confinement and discharge or Soldier completes
confinement without discharge.
confinement. When Soldiers are under investigation for, or charged with, a
civil criminal offense (misde-
meanor or felony) and they are incarcerated in civilian
confinement, pre or post trial, or are being held pending psychiatric
evaluation or treatment, they are ineligible to continue any phase of the DES.
If they are present for duty (on bail), they are eligible to complete the MEB.
The Soldier, to include if on bail, becomes eligible for the PEB or disability
disposition when the Soldier is cleared of the offense and has a military
status (continues on active duty or in an RC active status), or the command,
after conviction, specifically declines in writing to separate the Soldier on
the basis of conviction by civil court (see AR 135–175, AR 135–178, AR
600–8–24, and AR 635–200).
with military suspended sentences. Soldiers may not be referred for, or
continue in, disability processing if under military sentence of dismissal or
punitive discharge unless the sentence is suspended. A copy of the military
order suspending the sentence must be included with the MEB packet forwarded to
the PEB. If, after forwarding the case to the PEB, the command takes action to
vacate the suspension, the PEBLO must notify the PEB. Disability processing may
resume if the commander decides not to vacate the suspension. The Soldier may
not be discharged through the DES process until the period of suspension has
ended and the punitive discharge or dismissal has been disapproved.
Enlisted Soldiers pending administrative separation.
Enlisted Soldiers who are approved for discharge in lieu of trial
by court-martial are ineligible for referral to the MEB and PEB phases of the
DES (see AR 635–200). If the Soldier is in the DES process, their DES case will
be terminated, and the Soldier is discharged in lieu of trial by court-martial.
Soldiers under processing for an administrative separation for
fraudulent enlistment or misconduct remain eligible to be referred to the MEB.
The Soldier’s commander must notify the Soldier’s PEBLO in writing that
administrative separation action has been initiated. The Soldier’s completed
MEB must be referred to the Soldier’s General Court-martial Convening Authority
(GCMCA) in accordance with AR 635–200 to determine whether the Soldier will be
referred to the PEB. Approval and suspension of an AR 635–200 separation action
is not authorized when the Soldier is pending both an AR 635–200 and AR 635–40
action. The GCMCA must decide which action to pursue (as described in AR
635–200). Soldiers continue to be eligible for these administrative separation
actions up until the day of their separation or retirement for disability even
though their PEB findings have been previously completed and approved by USAPDA
for the SECARMY. In no case will a Soldier, being processed for an
administrative separation for fraudulent enlistment or misconduct be discharged
through the DES process without the approval of the GCMCA.
For administrative separation actions other than those addressed
in paragraphs 4–3f(1) and 4–3f(2), referral and disposition
under the DES takes precedence over the administrative separation action.
Officers pending administrative elimination.
Generally, officers approved to resign for the good of the
Service in lieu of trial by court-martial are ineligible for referral to the
MEB and PEB. However, if the officer was referred to the MEB prior to approval
of the resignation, the MEB and/or PEB must be completed and the case dual
processed as described in paragraph 4–3g(2).
Officers pending administrative elimination under AR 600–8–24 are
normally dual processed for the elimination action and completion of the DES.
For dual processing to occur, referral to the MEB must occur before the date
the Deputy Assistant Secretary of the Army (Review Boards) approves the
adverse line of duty findings. A Soldier whose disability results from
intentional misconduct or willful neg-
ligence or was incurred during a period of unauthorized
absence or excess leave may be subject to administrative separation under AR
135–175, AR 135–178, AR 600–8–24, or AR 635–200, as applicable, without
referral to the DES for a fitness determination.
of imminent death or terminal illness. Expediting a Soldier’s case or
requesting that a Soldier’s case be
expedited for a Soldier having a prognosis of imminent
death is not authorized.
In certain circumstances, Soldiers may waive referral to
the DES process. The PEBLO must inform the Soldier about the DES process, their
right to a PEB, and the potential benefits of remaining in an active duty or
active Reserve status for purposes of completing the DES process. The Soldier
will be advised that they have the right to consult with a SMEBC prior to
waiving referral to the MEB or informal physical evaluation board (IPEB). The
Soldier must request a waiver in writing and such request, or an affidavit, must
attest that the Soldier has received the information described above and
declines referral to the PEB. The waiver must be filed in the Soldier’s health
records and official personnel record. Waiver requests are authorized in the
circumstances listed below.
The Soldier's conditions existed prior to service (EPTS). The
Soldier must be on continuous active duty for more than 30 days. The MEB must
provide clear and unmistakable evidence that the Soldier’s medical condition(s)
that do not meet medical retention standards are EPTS and did not permanently
worsen or progress beyond natural progression while on active duty
(specifically, were not service aggravated) (see DA Pam 635–40 for procedures).
The DES process would likely require extension past the date
of the Soldier’s ETS and the Soldier does not consent
Soldiers cannot be involuntarily retained past ETS even though
they may have a remaining service obligation.
Soldiers approved for separation under any program that incurs a
Reserve obligation, and who have condition(s) that are cause for referral to
the DES, may not waive the DES process.
Soldiers of the RC on active duty under a call to duty of more
than 30 days may continue the DES process upon release from active duty
(REFRAD). The Soldier must maintain a Ready Reserve status, sign a waiver
declining retention on active duty, and be counseled that the provisions of 10
USC 1207a (coverage of unfitting, non-service-connected disability) will not
apply when REFRAD occurs before the case is received at the PEB.
c. The DES process would likely require extension
past a Soldier’s established retirement date (other than retirement
under the Temporary Early Retirement Authority), and the
Soldier does not wish to delay retirement.
Soldiers who are pending permanent or temporary disability
retirement and who are eligible for a length of service retirement at the time
of their disability evaluation may elect to be retired for disability or for
length of service. However, when retirement for length of service is elected,
the Soldier’s retirement date must occur no later than the date the Soldier
would have been retired for disability.
Whether a Soldier may waive DES evaluation or disposition to
elect retirement under a Temporary Early Retirement Authority depends upon the
Temporary Early Retirement Authority eligibility policy in effect at the time
of the Soldier’s DES referral or disposition.
representation of Soldiers by SMEBC personnel will terminate on the Soldier’s
election for a FPEB, or upon
separation, retirement, or return to duty, whichever occurs
first. If a Soldier requests a FPEB and requests appointed counsel, the SMEBC
will transfer the case to the appropriate office of SPEBC. Upon request by
appointed SPEBC, the SMEBC will remain involved to assist the SPEBC throughout
the PEB and post-PEB appeals process. When requested, the SMEBC’s role will
continue to be covered by the provisions of AR 27–26.
representation by the SPEBC terminates upon a Soldier’s separation, retirement,
or return to duty.
traveling to a FPEB must be afforded sufficient time to arrive (more than one
duty day) in advance of their
scheduled hearing to confer with appointed legal counsel.
SMEBC and SPEBC will have access to information contained in computerized
databases and electronic medical records that relate to their clients’ medical
condition and DES case status. Access to information includes, but is not
limited to, documents in eMEB, ePEB, data not restricted under paragraph 4–22e,
Veterans Tracking Application, e-Profile, Armed Forces Health Longitudinal
Technology Application (AHLTA), and Healthcare Artifact and Image Management
SMEBC and SPEBC must receive the Soldier’s DES case file in a timely manner to
assist Soldiers with their timely DES elections and to prepare rebuttals, if
appropriate. Counsel’s failure to timely receive a Soldier’s DES case file will
constitute good cause to extend a Soldier’s DES election period.
Soldiers request appointed counsel, the SPEBC must be provided both the
Soldier’s DES case file and notice of a scheduled FPEB hearing at least 10 days
prior to the hearing. Normally, caseload for SPEBCs will not exceed ten
scheduled FPEB hearings per counsel per week. The MEDCOM SJA, in consultation
with the Director of the OSC, MEDCOM, may approve exceptions to this caseload
standard and will report any exceptions granted to the Director, Soldier and
Family Legal Services.
PEB will provide the Soldier’s SMEBC and/or SPEBC with a copy of all
correspondence, responses to appeals
or requests for VA rating reconsideration, and all other
documents directed to the Soldier.
The MEBTO is an established IDES service line component whose
mission is to enhance Army readiness by provid-
ing clear, concise RC IDES guidance, training, and
oversight to support the IDES enterprise.
The MEBTO will regulate all Component 2/Component 3
(excluding 10 USC AGR and RC Soldiers activated greater than 30 days) referrals
to designated IDES locations. The RC referring authorities will ensure all
referrals are processed in accordance with DA Pam 635–40.
The MTFs and/or MEB Remote Operating Centers will not accept
direct referrals of Component 2/Component 3 (excluding 10 USC AGR and RC
Soldiers activated greater than 30 days).
The RC will use the National Guard Bureau Health Information
System, Medical Electronic Data (for) Care History
and Readiness Tracking, and its sub-module named Medical
Evaluation Board Preparation Module to process MEB referrals through the MEBTO.
An MEB is convened to determine whether a Soldier’s medical
condition(s) meets medical retention standards per AR 40–501. With the
exception of cases referred by MAR2, an MEB may determine that a Soldier’s
condition(s) meet medical retention standards and recommend the Soldier be
returned to duty. (See para 3–5c, concerning MEB actions on
The MEB must not provide conclusions or recommendations
regarding fitness determinations.
From the time a Soldier receives a P3/P4 profile referring
them to a MEB until the time the DES process is completed
(including a decision on any appeal) or the Soldier is
returned to duty, the Soldier—
remain available for the DES process to complete any required actions. Leave,
while permissible, is generally discouraged in the MEB phase with the exception
of emergency situations. Commanders may grant leave as long as the leave or
other required absence is communicated immediately to the assigned PEBLO and
does not prevent timely completion of DES appointments. Commanders should
encourage Soldiers to use accrued leave after the IPEB adjudication when the
Soldier is not requesting a FPEB.
ineligible for assignment instructions or orders with the exception of orders
for assignment to the Warrior Transi-
tion Unit or Community Care Unit. If the Soldier has
already received assignment orders prior to initiation of the DES process, the
process must be completed and a final decision rendered before the Soldier
proceeds on assignment.
accordance with AR 614–100 and AR 614–200, is ineligible for permanent change
of station other than: (1) Home on permanent change of station leave under the
provisions of AR 600–8–10; or
(2) When required for a Soldier stationed outside the
continental United States to complete the DES. (Also see DA Pam
Is ineligible for transfer within a component or transfer
between components. This includes involuntary transfer to the IRR when the RC
Soldier is otherwise eligible to remain a member of the Selected Reserve during
(Also see para 4–8f.)
Is ineligible to be scheduled for or attend training for
which the U.S. Army Training and Doctrine Command is the proponent.
May extend their enlistment or be retained for medical
reasons to complete DES process, if otherwise eligible for such extension and/or
retention, under the regulations listed below. Requests for retention should be
approved unless the Soldier is disqualified for retention under another
provision of this regulation.
135–175 for retention of USAR and ARNG officers in RC active status.
135–178 for retention of USAR and ARNG enlisted Soldiers in RC active status.
601–280 for extension of enlistments.
635–200 for retention of enlisted Soldiers on active duty.
600–8–24 for retention of officers on active duty.
eligible for awards and for promotion consideration, promotion selection, and
promotion. (See AR 600–8–19 and
AR 600–8–29. See also paragraph 4–30 for grade issues in
relation to disability benefits and disposition.)
subject to the UCMJ, adverse administrative action, or separation pursuant to
AR 635–200. Partial or complete
dual processing may be required (see para 4–3).
Soldiers pending adverse actions or involuntary
administrative action are eligible for the DES as set forth in paragraph 4–
3. Disenrollment from DES, or termination of the case for
any other reason, will occur no earlier than as prescribed below.
Soldiers with an initiated or approved administrative separation for misconduct
or fraudulent enlistment will be disenrolled when the MEB is completed, the
Soldier’s GCMCA has reviewed the MEB, and the GCMCA has directed in writing to
proceed with the administrative separation. If the separation action was
initiated after the Soldier’s MEB was forwarded to the PEB, the last level of
approved PEB findings prior to initiation of separation will be provided to the
GCMCA for consideration in their decision.
pending an administrative elimination action are disenrolled from the DES on
the date the elimination action
is approved by the Army Review Boards Agency.
Soldiers and officers who are approved for discharge or resignation, as
applicable, in lieu of trial by court-
martial are disenrolled on the date the separation or
resignation is approved. (Also see paras 4–3f through 4–3g.)
and enlisted Soldiers who are under investigation for or charged with a UCMJ
offense that could result in a
punitive discharge will be disenrolled on the date the
punitive discharge has been approved by the Soldier’s GCMCA.
charged with civilian offenses that if charged under the UCMJ could result in a
punitive discharge are dis-
enrolled if the Soldier is—
or is otherwise not present for duty to complete the DES.
for separation or elimination action on the basis of civil conviction. For an
enlisted Soldier, the MEB must be completed and reviewed by the Soldier’s GCMCA
and the GCMCA must have directed in writing to proceed with the separation
action. For an officer, the MEB and PEB phase must be completed unless the Army
Review Boards Agency approved the elimination action before the Soldier was
referred to the MEB.
a. Generally, upon referral
into the DES, the physician approving the Soldier’s P3/P4 profile will initiate
the VA Form 21–0819 (VA/DOD Joint Disability Evaluation Board Claim) by
completing Section 1 and transmitting the form to the office designated by the
MTF commander. For Soldiers referred from outside the continental United States
and for RC Soldiers referred from a nonactive duty status, the MTF initiates
and completes VA Form 21–0819, Section 1. b. A PEBLO will be assigned
to the Soldier to—
Contact the Soldier to provide them with a general overview of
the DES process, review Section 1 of the VA Form 21–0819 with the Soldier, and
inform the Soldier of their right to be represented by an attorney during the DES
Notify the unit commander of the Soldier’s enrollment in the DES.
Verify with the Soldier’s unit commander whether there are any administrative
or UCMJ actions pending or initiated on the Soldier and/or whether the Soldier
is currently in civilian confinement awaiting trial or due to civilian
Initiate DA Form 5893 (Soldier’s Medical Evaluation
Board/Physical Evaluation Board Counseling Checklist). The Soldier and PEBLO
will initial and date counseling entries on the DA Form 5893 as counseling
occurs. The supervisor of the PEBLO will review checklists to ensure that
counseling occurs when required. At a minimum, the supervisor will document
their review by initialing and dating the DA Form 5893 in the instances listed
(a) Before the
PEBLO forwards the case to the PEB.
(b) When the
PEBLO counsels the Soldier on PEB results.
(4) Request a non-medical
assessment from the Soldier’s commander detailing the Soldier’s ability to
perform their current duties, using DA Form 7652. When required by AR 600–8–4,
ask the Soldier’s commander to conduct an LOD investigation (informal or
formal, as applicable) for referred conditions, and, upon approval of the
investigation, provide a copy of it in its entirety to the PEBLO.
(5) Gather the complete
service treatment record, including civilian medical records.
(6) Assemble the case
file as outlined in DA Pam 635–40.
(7) Forward the case file
to a VA military service coordinator (MSC).
(8) Advise eligible
Soldiers that they are required to begin the Soldier for Life – Transition
Assistance Program immediately (see para 4–31).
The Soldier will have the opportunity to claim conditions on
VA Form 21–0819, Section 3. After the Soldier, or a designated representative,
submits VA Form 21–0819 to the MSC, the Soldier may claim additional
conditions, but the VA will not evaluate the added claimed conditions until
after separation from Service unless the PEB refers the condition for further
VA or MEB evaluation before issuing a final fitness determination, or if the
MEB approving authority concludes that adding a new medical condition is
necessary to ensure the MEB findings adequately reflect the complete spectrum
of a Soldier’s injuries and illnesses. If desired, the Soldier may seek legal
advice from an attorney assigned as MEB counsel, private legal counsel retained
at their own expense, or a VA-accredited representative of a service
organization recognized by the Secretary of VA. Submission of a DD Form 2807–1
(Report of Medical History) or completion of VA Form 21– 0819, block 3, is
entirely voluntary. Involuntary information provided on those forms relating to
the origin, incurrence, or aggravation of a disease or injury will not be used
by DOD in any manner against the interest of the Soldier.
If the member testifies or makes a statement as to
information surrounding a restricted report of sexual assault to assist the PEB
in a fitness for duty or disability determination, the disclosure to the PEB
does NOT cause a restricted report to be considered unrestricted, and all
restricted reporting information remains confidential and protected.
The VA will arrange for qualified medical examiners to
perform the examination as required by the Army to complete
the MEB and PEB determination.
MTF commander or designee will appoint MEB members.
will be composed of two or more physician members. One of the MEB members will
prepare the NARSUM of the Soldier’s medical conditions. A senior medical
officer will serve as the MEB approving authority and will have detailed
knowledge of regulations pertaining to standards of medical fitness and
disability separation processing. The other member(s) will have working
knowledge of these matters. When a MEB is considering a dental condition, the
membership of the board will include a dentist. When a MEB is considering a
psychiatric diagnosis, the MEB will include a psychiatrist or a clinical
psychologist with a doctoral degree in psychology, who may also substitute for
the second MEB physician member. If the MEB members disagree on the case, the
MTF commander or designee may appoint an additional voting member to review the
proposed findings and provide the majority position.
Medical Evaluation Board composition for Medical Corps officers.
Unless otherwise directed by MEDCOM, the MEB for Medical Corps
(MC) officers will not be conducted by the MTF to which the MC officer is
assigned. A MC officer may appear before a board at another MTF within their
regional medical command provided the review authority is not in the officer’s
Requests for authority to deviate from policy regarding MEB
procedures for MC officers will be forwarded to MEDCOM (MCHO–CL–P), 2748 Worth
Road, Fort Sam Houston, TX 78234–6010. A copy of the approval, if granted, will
be attached to each copy of the board proceedings.
MEB will be held at San Antonio Military Medical Center for all
MC officers with duty station at Fort Sam Houston except those assigned to San
Antonio Military Medical Center and MEDCOM.
MEB members for MC officers assigned to MEDCOM will be appointed
by TSG or their designated representative.
MEB NARSUM is the heart of the MEB. The NARSUM will be prepared in accordance
with the procedures
outlined in DA Pam 635–40.
NARSUM will include the following information:
identification. Soldier name and PMOS spelled out.
(2) Sources and
(4) Diagnoses for DA Form
3947 (Medical Evaluation Board Proceedings). Include AR 40–501 citation for
diagnoses that do not meet medical retention standards.
(5) Medical retention
determination point statement.
(6) Profile review and/or
update and discussion. This is a crosswalk between conditions listed on the DA
Form 3349 and specific associated functional activity limitations. Note: It is
helpful for the MEB provider to specifically indicate they considered all
conditions listed in section 4 of the NARSUM.
(7) For each condition
that does not meet retention standards:
basis of diagnosis.
(b) Onset. (Duty
status; date symptoms began and/or condition diagnosed; geographical location;
mechanism of injury.) (c) Treatment Summary. Brief summary of
treatment; Soldier's response to treatment; current limitations.
issues, if any (see AR 600–20).
statement. Indicate whether it is likely that Soldier's condition will
significantly worsen or improve over the next five years.
on duty beyond profile limitations.
(g) Selection of
applicable AR 40–501 provision with tailored discussion.
(8) Competency statement. Where the
Soldier has one or more behavioral health diagnoses, the MEB provider indicates
whether the Soldier is:
competent for pay purposes.
(b) Capable of
understanding the nature of, and cooperating in PEB proceedings.
to themselves or others.
(9) Conditions meeting
Timeliness issues and/or quality check. In this section, the MEB
provider addresses any issues regarding timeliness of examinations and apparent
Signature of NARSUM provider and date signed.
Sources of information to prepare the NARSUM include the VA
examination, the DA Form 7652, pertinent clinical
records, and other records in the case file, as
The NARSUM preparer conducts an administrative review of
records, to include the VA medical examination. With reference to the VA
medical examination, the NARSUM preparer may seek clarification or correction
from the VA. The NARSUM preparer will resolve any inconsistencies regarding
diagnosis, onset, severity, and impact on duty. Where there is sufficient
information upon which to base a finding, no additional clinical evaluation is
required. Where there is insufficient evidence upon which to base a finding,
the MEB provider may obtain additional information from treating providers,
commanders, and/or the Soldier through phone, email, or, when necessary, a
non-clinical face-to-face meeting.
With reference to the proposed DA Form 3947 entries as
specified in the NARSUM, the PEBLO will prepare a draft DA Form 3947 using the
information set forth in section 4 of the NARSUM. The PEBLO will forward this
draft and the case file to the MEB members for review and signature.
The MEB will recommend that the case file be forwarded to a
PEB for a fitness determination when the MEB finds that one or more of a
Soldier’s medical conditions individually or collectively do not meet medical
retention standards. The MEB will recommend the Soldier be returned to duty or
returned to duty with limitations when the MEB finds all medical conditions
meet retention standards, and the Soldier was not referred by MAR2. See
paragraph 3–5c, regarding the Soldier referred by MAR2.
In cases where the Soldier has been determined mentally
incompetent, a statement confirming the name, address, telephone number, and
relationship of a person authorized to act on behalf of the Soldier, whether
this person is available for counseling following PEB action, and whether the
person has been advised of the referral to a PEB must be included in the MEB
documents. If the next-of-kin is not known or cannot be located and no
court-appointed guardian exists, include a summary of the attempts to identify
or locate the next-of-kin. To establish the person having authority to act for
a mentally incompetent Soldier, in the absence of a valid, durable, and
pertinent power of attorney (dated before the finding of incompetence) or a
court order authorizing an individual to act for a mentally incompetent
Soldier, follow the guidelines below. The person authorized to act is the
person highest in the line of authority listed below.
even if a minor.
sons or daughters in order of seniority. A person is an adult upon reaching the
age of majority under the state law of the person’s legal residence.
in order of seniority, unless legal custody was granted to another person by
reason of court decree or statutory provision. The person to whom custody was
granted remains as next-of-kin although the person has reached the age of
or adoptive relative who was granted legal custody of the person by reason of a
court decree or statutory provision. The person to whom custody has been
granted remains the nearest next-of-kin although the person has reached age of
brothers and sisters in order of seniority.
in order of seniority.
relatives in order of relationship to the Soldier and according to the laws of
the Soldier’s domicile. A Soldier’s domicile is the Soldier’s legal residence.
It is not necessarily where the Soldier is actually living, the Soldier’s home
of record, or where the Soldier is stationed.
who stand in place of a parent. Seniority in age will control when the persons
are of equal relationship.
No individual will serve as both the MEB approval authority
and MEB appellate authority.
If information about a restricted report of sexual assault
comes to a commander’s attention as a result of a disclosure that is required
for fitness of duty or disability determination, the commander will not report
the matter to an military criminal investigative organization. The nature of
the report shall remain restricted and the disclosure of information shall only
be used to assist the command in preparing input to the medical board via the
non-medical assessment; and the victim’s communications remain confidential.
Following the MEB decision, the PEBLO will inform the Soldier
of their election options. These election options include both an option to
request an impartial medical review (IMR) and an option to submit a rebuttal of
the MEB findings. With respect to these two options, the PEBLO will inform the
Soldier that they may seek legal advice from an attorney assigned as MEB
counsel, private legal counsel retained at their own expense, or a VA accredited
representative of a service organization recognized by the Secretary of VA.
The Soldier must sign the DA Form 3947 within five days of
receiving and being counseled on the MEB findings, unless an extension is
granted for good cause (for example, appointed legal counsel is unavailable).
Absent an approved extension, the MEB decision becomes final on the fifth day,
and the MEB convening authority will authorize the PEBLO to forward the case
file to the servicing PEB. In cases where the Soldier does not sign the DA Form
3947, the PEBLO will add to the case file a memorandum describing the efforts
to contact the Soldier or indicating the Soldier was found to be incompetent by
the MEB. The Soldier’s signature on the DA Form 3947 indicates one of the following:
(1) The Soldier concurs
with the MEB decision.
(2) The Soldier requests
(3) The Soldier does not
request an IMR, does not concur with the MEB findings, and has an additional
seven days to submit a written rebuttal.
The purpose of the IMR is to inform the Soldier whether (in
the IMR reviewer’s opinion) the MEB findings ade-
quately reflect the complete spectrum of the Soldier’s
injuries and illnesses. Generally, a Soldier may request one IMR. If the PEB
returns a Soldier’s case for further VA and MEB evaluation of a new medical
condition as provided for in paragraph 4–10c, the Soldier will have an
opportunity to request another IMR; however, it will be limited in scope to
addressing the MEB findings for the PEB-returned condition.
The MTF commander or designee will appoint a physician or
other appropriately credentialed provider to conduct
the IMR. This impartial medical reviewer must not be either
the MEB approval authority or a member of the MEB.
The impartial medical reviewer will examine the medical
evidence as presented in the NARSUM and all other MEB information to include
the completed VA examinations and all records the Soldier intends to submit for
inclusion within the MEB.
Within five days of being appointed to conduct the IMR, the
impartial medical reviewer will prepare their findings and inform the Soldier
of whether the MEB findings adequately reflect the complete spectrum of the
Soldier’s injuries and illnesses. They will sign the DA Form 3947 and forward
their findings to the PEBLO and the counsel of record, if any.
Where the IMR findings indicate that the MEB does not
adequately reflect the complete spectrum of the Soldier’s injuries and
illnesses, the MEB approval authority will appoint an appropriately
credentialed provider (who may be a member of the MEB) to consider the IMR
findings. Barring unusual circumstances, when the Soldier requests an IMR and
submits an MEB rebuttal, the same individual will consider both the IMR
findings and the MEB rebuttal, respectively. In unusual circumstances, the MEB
appeals authority may forward the IMR findings and the MEB rebuttal to TSG or
another MTF for adjudication.
Within seven days of receiving the IMR findings, the MEB
approval authority will uphold the original NARSUM or
return the NARSUM to the NARSUM preparer for
The MEB approval authority will include a document
specifically prepared in response to the IMR findings explain-
ing the foundation for conclusions; whether these
conclusions are that no changes are warranted in the NARSUM or other MEB
document, or that additional consideration has caused the NARSUM preparer to
revise the NARSUM or any other MEB component. The MEB approval authority will
advise the PEBLO once all action is completed.
The PEBLO will provide a copy of the MEB approval authority’s
response to the IMR to the Soldier and the Soldier’s appointed counsel (if
counsel is identified on the IMR request as a point of contact).
Within seven days after Soldier and the PEBLO receive the IMR
findings indicating the MEB adequately reflects the complete spectrum of the
Soldier’s injuries and illnesses, or within seven days of Soldier being
informed by the PEBLO of the MEB approval authority’s response to the IMR, the
Soldier may submit a written MEB rebuttal to the PEBLO. Upon request by the
Soldier or their representative and when good cause is shown, the MEB approval
authority will extend this time period.
Provided the Soldier has not requested an IMR, the Soldier
may submit a written MEB rebuttal to the PEBLO within
seven days after signing the DA Form 3947. Upon request by
the Soldier or their representative, the MEB approval authority will extend
this time period when good cause is shown.
When the Soldier has requested an IMR, the Soldier may submit
a written MEB rebuttal to the PEBLO within seven days after the Soldier and the
PEBLO receive the IMR findings indicating the MEB adequately reflects the
complete spectrum of the Soldier’s injuries and illnesses or within seven days
of the Soldier being informed by the PEBLO of the convening authority’s
response to the IMR review. Upon request by the Soldier or their
representative, the MEB approval authority will extend this time period when
good cause is shown.
In general, the Soldier may submit only one written MEB
rebuttal. The Soldier may submit an additional MEB rebuttal when the MEB
revises its prior findings with respect to adding or removing diagnoses and/or
revising prior MEB findings with respect to whether one or more conditions is
cause for MEB referral. Any additional MEB rebuttals will be limited to issues
relating to MEB revisions.
The MTF commander will appoint a physician or other
appropriately credentialed provider to address the Soldier’s MEB rebuttal.
Barring unusual circumstances, when the Soldier requests an IMR and submits a
MEB rebuttal, the same individual will consider both the IMR findings and the
MEB rebuttal, respectively. Within seven days of the MEB approval authority
receiving the MEB rebuttal, the MEB approval authority will uphold the original
MEB, amend the findings, or return it to the MEB. In unusual circumstances, the
MEB appellate authority may forward the IMR findings and the MEB rebuttal to
TSG or to another MTF for adjudication.