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

date the packet is mailed to the PEB. Decisions regarding unfitness for further military duty because of physical or
mental disability are prerogatives of PEBs (see AR 635-40). MEBs will not express conclusions or recommendations
regarding such matters. However, entrance physical standards boards (EPSBDs) will make decisions as to the member’s
fitness or unfitness for enlistment or induction.
7–2. Appointing authority
MTF commanders; Commander, TSG/Commander, USAMEDCOM; and Commander, 18th MEDCOM; are authorized
to appoint MEBs.
7–3. Composition
MEBs will be composed of two or more physician members. One will be a senior medical officer with detailed
knowledge of directives pertaining to standards of medical fitness and disposition of patients, disability separation
processing, and the Veterans Affairs Schedule for Rating Disabilities (VASRD). It is further encouraged that the
physician use the VA Physicians’s Guide for Disability Evaluation Examinations to describe the nature and degree of
severity of the member’s condition. The other member(s) will be familiar with these matters. When a board is
considering conditions which normally fall within the professional jurisdiction of the Dental Corps, the membership of
the board will include a dentist. Likewise, a board considering a psychiatric problem will include a psychiatrist. In
consideration of mental competency, the MEB will consist of at least three members, one of whom will be a
psychiatrist.
7–4. Medical board procedures for Medical Corps officers
MEBs will not be done by the MTF to which a Medical Corps (MC) officer is assigned. MC officers may appear
before a board at another MTF within their RMC provided the review authority is not in the officer’s rating chain. In
unusual circumstances, requests for authority to deviate from this policy may be forwarded to USAMEDCOM, ATTN:
MCHO-CL-P, 2050 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. An exception to this policy has been granted to MC officers assigned
to Fort Sam Houston, TX as in a and b below.
a. MEBs will be held at Brooke Army Medical Center (BAMC) for all MC officers with duty station at Fort Sam
Houston except those assigned to BAMC and USAMEDCOM.
b . M E B o f f i c e r s f o r M C o f f i c e r s a s s i g n e d t o U S A M E D C O M w i l l b e a p p o i n t e d b y T S G o r a d e s i g n a t e d
representative.
7–5. Use of medical evaluation boards
a. Only those patients that present problematical or controversial aspects and those in which MEB action is required
by regulation should be referred to the MEB before disposition. Patients who will be returned to duty without any
permanent revision to their physical profile and those who require transfer to another hospital before final disposition
normally should not be considered by an MEB before such disposition. When patients are transferred, the losing MTF
will forward all medical and administrative MEB documents to the gaining MTF having geographical responsibility.
b. Situations that require MEB consideration are—
(1) Those in which PEB referral is contemplated for other than TDRL periodic examinations. (See para 7-21.) It is
essential that the MEB evaluate thoroughly and report all abnormalities and their impact on fitness for duty. Correlation
must be established between the abnormalities and the inability to perform duties. This is particularly important when a
chronic condition is the basis for referral to a PEB and there has been no change in the severity of the condition.
(2) Those involving patients with medical conditions or physical defects that are usually progressive in nature and
expectations for reasonable recovery cannot be established. The MEB must ensure that adequate documentation is
made of the nature, extent, and cause of all medical conditions or physical defects in question.
(3) Those involving patients whose medical fitness for return to duty is questionable, problematical, or controversial.
When a member’s fitness for further military duty is questionable, it becomes essential that all abnormalities in his or
her condition be thoroughly evaluated. Under these conditions, evaluation will be undertaken only in an MTF that has
the necessary professional staffing and equipment. Also, the MTF must have the administrative competence and
experience to document the case fully and to initiate the member’s processing. Otherwise, the member will be
transferred to the nearest Army MTF that has the capability.
(4) Those involving RC personnel on authorized duty—
(a) Whose fitness for further military service upon completion of hospitalization is questionable.
(b) Who require hospitalization beyond the termination of their tour of duty.
(5) Those involving an RC member not on AD who require evaluation because of a condition that may render him
or her unfit for further duty. If the condition is the result of injury incurred while on authorized duty for 30 days or
less, the case may be referred to a PEB as provided in paragraph 7-21. RC members with a disabling condition
incurred under other circumstances will be processed under provisions of AR 40-501. RC personnel with a nonduty
related condition pending separation for medical disqualification are entitled to a PEB.
AR 40–400 27 January 2010
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