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

Table 7–1
Distribution of medical board proceedings (See notes 1 and 2)
Type of Disposition Health Record Copy No. Clinical Record Copy No. Hospital Copy No. Other Copy No.
1. Returned to duty 1 2 3
2. Retained under medical
jurisdiction for later
evaluation
3. Referred to physical
evaluation board
4. Separation not for disability:
1 2 3
a. Release from AD RC 1 2 3
b. Discharge 1 2 3
5. EPTS separation not
referred to PEB
7 8 1 through 6 to PEB
1 2 3 4 copy of DD Form 2808
and DD Form 2807–1 attached
to Cdr U.S. Army
Recruiting Command
ATTN: RCCS-SURG, Fort
Knox, KY 40121. (See AR
635-40.)
Notes:
1 See AR 635-40 for disposition of DA Form 3947 when a disabled individual is continued on AD.
2 See AR 40-501 for instructions on the use of DA Form 3349 to notify unit commanders of physical profile and assignment limitations on members returned
to duty.
7–10. Preparation of DA Form 3947
The following instructions apply to preparation of DA Form 3947:
a. Items 1 through 11. Obtain from personnel or medical records.
b. Item 12. Check applicable box.
c. Item 13. List all diagnoses in descending order of significance. For cases being recommended for referral to the
PEB, note applicable paragraph in AR 40-501.
d. Item 14. Check the applicable box. If the MEB finds the Soldier qualified for retention but requires duty
limitations, list all limitations. DA Form 3349 must always be attached. Patients whose medical condition(s) and
physical defect(s) meet the criteria of AR 40-501 will be recommended for referral to a PEB. MEBs on all Soldiers
referred to the PEB must include an updated DA Form 3349 which lists all duty limitations.
e. Items 15 and 16. Check the appropriate box. If continuation is requested and it is medically feasible, indicate
assignment limitations and profile in item 30.
f. Items 17 through 19. When a board member must be qualified in a specific medical specialty, enter the specialty
after name and grade.
g. Items 20 through 22. Check the appropriate boxes. If either item 20 or 21 is checked, the approving authority will
attach an enclosure stating the reason for return or referral.
h. Item 23. The MTF commander may delegate approving authority to a senior MC staff member with detailed
knowledge of directives pertaining to standards of medical fitness and disposition of patients, disability separation
processing, and the VASRD.
i. Item 24.
(1) If the patient is located in the vicinity of the MTF, he or she will be advised of the approved findings by the
PEBLO and asked to check the appropriate box. If the patient disagrees with the findings, he or she will be asked to
prepare a statement citing reasons for disagreement. The statement will be attached. The patient is authorized 3
working days to decide his or her election. Extensions of time beyond 3 working days may be granted for reasonable
cause such as desire to consult with legal counsel, and so forth. If the patient does not make an election, the case will
be forwarded as if approved by the member. Refusal or inability on the part of the patient to make an election will
require an explanatory note in the board proceedings.
(2) When the patient is not at the MTF, a certified letter will be sent by the MTF advising the member of the
board’s recommendations and requesting a written reply indicating his or her agreement or disagreement. A copy of the
complete MEB report will be attached to the letter. The letter will indicate that the member has 3 working days
following receipt of the letter to forward his or her election to the MTF. Extensions of time beyond 3 working days
may be granted for reasonable delays. MEB processing, receipt of the Soldier’s election and forwarding to the PEB is
completed at the originating MTF. If the member does not make an election, the case will be forwarded as if approved
AR 40–400 27 January 2010
57