Patient Administration - Army Publishing Directorate - U.S. Army

Disability separation
Temporary or permanent retirement and discharge for physical disability, with or without entitlement to receive
severance pay.
Disposition
The discharge of a patient from a MEDCEN or hospital, that is, a discharge to duty or home, transfer to another MTF,
death, or other termination of inpatient care.
Domiciliary care
Inpatient institutional care provided the beneficiary not because it is medically necessary, but because the care in the
home setting is not available, is unsuitable, or members of the patient’s Family are unwilling to provide the care.
Institutionalization because of abandonment constitutes domiciliary care.
Note. Domiciliary care and custodial care represent separate concepts and are not interchangeable.
Elective care
Nonemergency care that, in the opinion of the cognizant medical authority, is not medically required but is requested or
p r e f e r r e d b y t h e p a t i e n t . E x a m p l e s a r e : f a c e l i f t , v a s e c t o m y , a u g m e n t a t i o n m a m m o p l a s t y , a b d o m i n o p l a s t y , a n d
liposuction.
Emergency care
a. Medical treatment of patients with severe life-threatening or potentially disabling conditions resulting from
accident or illness of sudden onset. These conditions necessitate immediate care to prevent undue suffering or loss of
life.
b. Dental treatment for relief of painful or acute conditions.
Existed prior to service
A term added to a medical diagnosis to signify there is clear and unmistakable evidence that the disease or injury or the
underlying condition producing the disease or injury existed prior to the individual’s entry into military Service.
Family members
a. Family members of members of the Uniformed Services. Family members include persons who are related ((1)
through (5) below) to an AD Soldier who is serving under a call or order that does not specify a duty period of 30 days
or less. Persons are also Family members if the Soldier died while serving on such AD, is retired, or died while in a
retired status. This includes Family members of retired members of RC if the member died while under 60 years of age
and chose to take part in the Survivor Benefit Plan. In such a case, the Family member’s entitlement becomes effective
on the date the deceased retiree would have been 60 years of age. Categories of Family members and their specific
entitlements are as follows:
(1) Spouse, even if not actually dependent on the AD or retired member.
(2) The unremarried former spouse of an active or retired member whose marriage to the member was dissolved on
or after 1 February 1983 who—
(a) On the date of marriage dissolution had been married to the member for at least 20 years during which time the
member performed at least 20 years of service that is creditable in determining eligibility for retired or retainer pay.
(b) Does not have medical coverage under an employer-sponsored health plan.
(3) Unremarried widow or widower even if not actually dependent on the AD or retired member at the time of the
member’s death.
(4) A legitimate child, an illegitimate child who has been legitimized or whose paternity has been judicially
determined, an adopted child who is adopted before age 21, or stepchild, who is unmarried and is—
(a) Under 21 years of age even if not dependent on the AD or retired member.
(b) Twenty-one years of age or older but incapable of self-support due to a mental or physical disorder that existed
prior to his or her 21st birthday (23rd birthday if in student status) and is, or was at the time of death of the AD or
retired member, dependent on the member for over one-half of his or her support. (Sponsor must submit a request for
dependency determination to DFAS. A medical sufficiency statement must accompany request. See AR 600-8-14 for
sample medical sufficiency statement.)
(c) Twenty-one or twenty-two years of age and pursuing a full-time course of education. The course must be
approved by the Secretary of Defense or the Secretary of Education, as applicable, or by a State agency under 38 USC
1775. Further, the person must be, or must have been at the time of death of the AD or retired member, dependent for
over one-half of his or her support. A child in this category, who during the school year or between semesters suffers a
disabling illness or injury that interrupts attendance at the institution, remains eligible for care until 6 months after the
disability is removed or until his or her 23rd birthday, whichever occurs earlier.
Note. A child includes an unmarried child of a male member who was illegitimate at the time of birth and who is, or was at the time
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