a. Once a physician (an MD Doctor) determines that a wounded soldier has reached optimal medical care and still remains unfit for further military duty, the Doctor/Physician will refer the wounded soldier for a MEB. This can be done through a referral form and/or a permanent profile with a “3” or “4” designator in the PULHES portion. This designator identifies the wounded soldier with significant limitation in their physical ability in that particular section. The referral or permanent profile is then forwarded to the PEBLO, Physical Evaluation Board Liaison Officer, who will contact the wounded soldier telephonically and arrange an appointment to start the MEB process. Wounded soldiers are required to attend a mandatory process briefing.

b. The MEB consists of three phases of medical evaluation. Once they are completed, the MEB packet is sent to the Physical Evaluation Board (PEB) for adjudication. Disposition can include:

·       Fit for Duty (FFD),

·       Separation from Service,

·       Temporary Disabled Retirement List (TDRL),

or

·       Permanent Disabled Retirement List (PDRL)

If a wounded soldier is found FFD, he or she is retained and works within the limitations of their profile. If a Wounded soldier is found unfit for duty, the PEB also determines the percent of unfitness. This percentage is based on the Veterans Affairs Schedule for Rating Disabilities (VASRD), ranging from 0 - 100% disabled. TDRL are for wounded soldiers who would be entitled to Permanent Disability Retirement except that the disability is not stable for rating purposes. TDRL is not a permanent status and the wounded soldier is required to undergo a reevaluation every 12-18 months for up to five years. Permanent disability retirement occurs if the disability is determined permanent and stable and rated at a minimum of 30% or the wounded soldier has 20 years of active federal service.

c. If a wounded soldier is separated from the Army, they may be entitled to severance pay. Severance pay is NOT a medical retirement. It is calculated by your base pay, multiplied by two, and then multiplied again by the number of years of active duty service (maximum of 12 years). If separated with severance pay, the wounded soldier will not receive retirement or be entitled to any future military benefits.

d. There may be a difference between the Army (PDES) and the Department of Veterans Affairs (DVA) ratings. The PDES rates and compensates soldiers for loss of their ability to perform their Army duty. Additional conditions that do not affect a Wounded soldier’s ability to perform his duty are not rated. The DVA may rate any service-connected impairment, thus compensating for loss of civilian employability. Wounded soldiers are encouraged to file a claim with the VA for all service-connected impairments.  HOWEVER:  WRAMC and the Department of Veterans Affairs (VA) are conducting a PILOT program.  The PEDS military disability system at WRAMC now uses the SAME disability criteria as the VA for its PEB findings.  This does not mean that a wounded soldier who is separated/Disability Retired from the service because of the PEB does not have to apply for VA Disability--they do, it's just that the official findings of the PEB are used by the VA to evaluate VA disability percentages -- for WRAMC wounded soldiers they are the SAME.

e. Wounded soldiers have 72 hours after notification of MEB results to rebut the board decision. When making a rebuttal to the MEB findings, the wounded soldier has several options:

- CONCUR (AGREE) with the MEB’s findings and recommendations. In this case the MEB is then forwarded to the PEB for adjudication.

- NONCONCUR (DISAGREE) with the MEB’s findings and recommendations.  The Wounded soldier may present a written appeal or any new evidence concerning the case to the informal board through the PEBLO.

- If a wounded soldier does not respond to the MEB in the prescribed time, he is presumed to agree with the findings.

- Wounded soldiers who disagree with MEB’s findings and recommendations will have their case reviewed by the Deputy Chief of Clinical Services (DCCS).

The DCCS may take one of the following actions:

(1) Original findings and recommendations are confirmed.

(2) The report of the board is returned for reconsideration.

(3) The report of the board is forwarded to the PEB with the wounded soldier’s comments attached as enclosures.

f. Wounded soldiers found not meeting retention standards by a MEB are referred to the PEB for final adjudication and determination of the severity of physical impairment if found unfit for service.

g. Once the appropriate records are assembled, the case is forwarded to one of three US Army Physical Evaluation Boards (PEBs), Walter Reed Army Medical Center (WRAMC), Ft. Sam Houston, TX or Ft. Lewis, WA. These boards review the files and determine the wounded soldier ’s physical fitness or unfitness to perform his or her military duties, based upon the nature of the medical condition and the requirements of the Wounded soldier ’s MOS.

h. Initially, the PEB will review the case at an informal evaluation board and make an informal determination that the wounded soldier is either FIT or UNFIT for service. If the informal board finds the wounded soldier unfit, the board will utilize the VA Schedule for Rating Disabilities (VASRD) as a guide for determining the disability rating. The informal evaluation is then returned to the wounded soldier and the PEBLO for agreement or disagreement. The Wounded soldier then indicates agreement or disagreement.

i. In accordance with AR 635-40, the wounded soldier has 10 working days from receipt of notification from the PEB to return the election statement. If the election statement is not returned to the PEB within the prescribed time, the wounded soldier is presumed to agree with the PEB recommendation and the case is forwarded to the PDA for final processing.

j. Choices for election of PEB findings:

(1) CONCUR (AGREE) and WAIVE a FORMAL board evaluation.

- Wounded soldier agrees with the informal board findings and does not want the case presented for formal board proceedings.

- Case is processed by the PEB for return to duty, separation, or retirement, depending upon the informal board recommendations.

(2) NONCONCUR (DISAGREE) and WAIVE a FORMAL board evaluation.

- Wounded soldier disagrees with the findings of the informal board, but does not want the case presented to a formal board. wounded soldier may present a written appeal or new medical evidence concerning the case to the informal board to reconsider its original findings.

(3) NONCONCUR (DISAGREE) and DEMAND a FORMAL board evaluation.

- Wounded soldier disagrees with the findings of the informal board and wants the case presented to a formal board. The wounded soldier may elect to NOT PERSONALLY APPEAR and have the case presented by legal counsel or to PERSONALLY APPEAR at the formal board.

- The wounded soldier has the right to legal representation. The purpose of Legal counsel is to ensure that the wounded soldier ’s rights are protected and that all relevant medical and administrative facts concerning the case are presented to the board.

- The formal board is a fact-finding board and will consider the case independently of the informal board. The formal board may adhere to the original informal board, or change the findings and recommendations.

k. After the formal board, the wounded soldier will, again, receive notification of the board’s findings indicating the new evaluation of disability. The wounded soldier again has 10 working days to CONCUR (AGREE) or NONCONCUR (DISAGREE) for the election to reach the PEB.

l. If the wounded soldier fails to concur or nonconcur with the formal board within the prescribed time, it is presumed to indicate agreement with the PEB recommendation, and the case will be forwarded to the PDA for final processing.

- 5-year tenure max.

- Periodic re-exams (18 months).

m. The PEB will make one of the following recommendations:

(1) Recommend FIT FOR DUTY.

(2) Recommend Permanent Disability Retirement Separate with Severance Pay (SWSP).

- 0% - 20% rating and less than 20 years service.

- Pay computed as: Basic Pay x 2 x years of service (YOS) (max 12 Yrs).

(3) Separate without Benefits (SWOB).

- Not-in-Line-of-Duty.

- Existed prior to service & not service aggravated and less than 8 years of active duty.

(4) Permanent Disability Retirement (PDR).

- 20 years of service computed under 10 USC 1208 or;

- 30% or higher rating and condition is stable.

- Pay is computed as the higher of the disability rating or the YOS percentage (2.5 x YOS) multiplied against “retired pay base.”

(5) Temporary Disability Retirement List (TDRL).

- PDR eligible AND the disability is not stable for rating.

n. If it is determined that a condition is pre-existing without permanent service aggravation, the service member may still be covered for disability severance or retired pay if the Wounded soldier has accumulated 8 years of active duty.

o. Regardless of the findings of the PEB, the wounded soldier should contact the VA and file a claim. VA determinations concerning entitlements to disability compensation are made independently of the Army. A wounded soldier MAY NOT receive payments from the VA while on active duty. However, wounded soldiers should apply to the VA immediately upon retirement or separation.  Even if the wounded soldier has a disability percentage from the PEDS (MEB/PEB) they have to apply to the Department of Veterans Affairs for VA Disability.

p. For additional information on the Medical Board Process, consult with your PEBLO.

q. Most boards will take four to six months to complete from the time the PEBLO is notified until final disposition.

r. See AR 635-40, Physical Evaluation for Retention, Retirement, or Separation, for information on the MEB/PEB process.

s. See AR 40-501, Standards of Medical Fitness, for information on medical fitness standards for retention and separation.

t. See AR 40-400, Patient Administration, for Narrative Summaries. The recommended format for an MEB narrative summary is provided below.

(1) Baseline documentation: physician’s specialty, MTF and location, reason for MEB, military history, chief complaint, history of present illness, past medical history, etc.

(2) Physical Examination.

(3) Laboratory studies.

(4) Present condition and current functional status.

(5) Conclusions.

(6) Diagnosis.

(7) Profile (as required).