Medical Evaluation Boards

Title 10, U.S.C., chapter 61, provides the Secretaries of the Military Departments with authority to retire or separate members when the Secretary finds that they are unfit to perform their military duties because of physical disability. The functional proponent for the Physical Disability Evaluation System (PDES) is the U.S. Army Physical Disability Agency (USAPDA). The Subordinate Physical Evaluation Board (PEB) is located at USAPDA; Fort Sam Houston, Texas.
Your primary care doctor recommends a Medical Evaluation Board (MEB). Your case is referred to and evaluated by a Medical Board Physician who initiates a permanent profile if warranted. If a permanent 3 or 4 level profile is issued the Soldier will be contacted by a Physical Evaluation Board Liaison Officer (PEBLO). The Soldier is enrolled in the Integrated Disability Evaluation System (IDES) and an MEB is undertaken. During the MEB process the Soldier will be evaluated by the Veterans Administration and a VA liaison will also be assigned to assist with Soldier. The Soldier's packet is forwarded to the Physical Evaluation Board for a final decision. Once results are received, the Soldier is counseled on his/her elective options. The Medical Boards Section and the Integrated Disability Evaluation System (IDES) is located on the 2nd floor of Munson Army Heath Center.

Soldiers are referred into the PDES in five ways:

• 1. Medical Evaluation Board (MEB)
• 2. MOS Administrative Retention Review (MAR2)
• 3. Fitness for Duty Medical Examination
• 4. HQDA Action
• 5. RC Non-duty Related Process

Counseling 

The individual responsible for counseling Soldiers referred into the PDES with a MEB is the Military Treatment Facility (Munson Army Health Center) Physical Evaluation Board Liaison Officer (PEBLO). The PEBLO counsels the Soldier on MEB/PEB findings and related rights and benefits. If the MTF determines that the Soldier is not mentally competent, the PEBLO counsels the designated next-of-kin. 

Fitness Standard 

The standard for determining fitness is whether the medical condition precludes the soldier from reasonably performing the duties of his or her office, grade, rank, or rating.

1. Worldwide deployability: Inability to perform the duties of office, grade, rank or rating in every geographic location and under every conceivable circumstance will not be the sole basis for a finding of unfitness. Deployability is a primary consideration in determining fitness.
2. Performance-based: The PDES relies heavily on the performance data provided by the soldier's immediate commander. Variance in case findings is often the result of inadequate information being provided relative to the soldier's duty performance.

Presumption of Fitness 

When a Soldier is referred for physical disability evaluation after having applied for length of service retirement, or an officer is within twelve months of mandatory retirement, or an enlisted Soldier is within 12 months of his or her retention control point with retirement eligibility, the Soldier enters the disability system under the presumption that he or she is physically fit. This is known as the Presumption of Fitness Rule. (This rule is not applied to RC cases referred under the non-duty related process described at paragraph 2c(5) above.)

1. Philosophy: The Soldier is presumed fit because he or she has continued to perform military duty up to the point of retirement for reasons other than physical disability. Disability retired pay is to compensate a Soldier whose career is terminated solely for reasons of disability.
2. History: The presumption rule originated as DoD policy in 1973 as a result of Congressional dissatisfaction with general ranked officers and medical officers retiring for physical disability when they were eligible for length of service retirement.

Overcoming the presumption 
Application of the Presumption of Fitness Rule does not mandate a finding of fit. It is a rebuttal presumption that is overcome if the preponderance of evidence establishes the circumstances described below per DOD Instruction 1332.38.

1. Acute, grave illness or injury: Within the presumptive period an acute, grave illness or injury occurs that would prevent the member from performing further duty if he or she were not retiring; or
2. Deterioration of a chronic condition: Within the presumptive period a serious deterioration of a previously diagnosed condition, to include a chronic condition, occurs and the deterioration would preclude further duty if the member were not retiring; or
3. Inadequate duty performance: The condition for which the member is referred is a chronic condition, and a preponderance of evidence establishes that the member was not performing duties befitting his or her experience in the office, grade, rank, or rating before entering the presumptive period.

Rating Schedule

Once a determination of physical unfitness is made, the VA will render a disability rating.

Disposition

• 1. Coverage for pre-existing disabilities
• 2. Permanent Retirement
• 3. Temporary Retirement
• 4. Separation with Severance Pay
• 5. Separation without Benefits
• 6. Fit for Duty

Periodic Medical Reexamination and Tenure

When placed on the Temporary Disability Retirement List (TDRL), the law requires the member to undergo a periodic medical reexamination within 18 months followed by PEB evaluation. The Soldier may be retained on the TDRL or final determination may be made. While the law provides for a maximum tenure of 3 years on the TDRL, there is no entitlement to be retained for the entire period.

Factors affecting compensation

Military disability compensation is based on disposition, rank, and years of service.

1. Retired pay: For permanent retirement or placement on the TDRL, compensation is based on the higher of two computations:
   • Disability rating times retired pay base; or,
   • 2.5 x years of service x retired pay base.

Soldiers on the TDRL receive no less than 50% of their retired pay base. The definition of retired pay base depends upon when the Soldier entered the service. For those who entered prior to 8 September 1980, it is the highest basic pay received. For those who entered after 7 September 1980, it is the average of the highest individual of 36 months of basic pay.

2. Severance pay: Disability severance pay equals 2 months basic pay for every year of service not to exceed 12 years.
3. Promotion selection: Soldiers who are to be retired for disability who are on a promotion list will be retired at the higher grade. However, for those Soldiers who entered the military after 7 September 1980, the definition of retired pay base results in no impact on retired pay. Soldiers being separated for disability who are on a promotion list will receive increased severance pay, since it is based on the basic pay of the Soldier's grade.

Fort Leavenworth Armed Forces Wellness Center

Mission

The Armed Forces Wellness Centers (AFWC) are an actionable platform delivering evidence-based programs that improve individual and unit performance and readiness, utilizing advanced testing technology to provide immediate feedback to improve Service Member readiness delivered by highly trained health & human performance professionals.

Along with improving fitness, AFWC programs can directly impact readiness by reducing lost or limited duty time and the number of Service Members on physical profile. The primary goal of the AFWC program is to reduce the risk of musculoskeletal injury, improve overall performance, and enhance the self-efficacy of individuals to maintain lifelong healthy behaviors. AFWCs are integrated with the Patient Centered Medical Home as part of the Comprehensive Care Plan.

Vision

Lead in the delivery of the most effective primary preventative health and wellness services that improve the overall well-being of Service Members, Retirees, Family Members, and Department of Defense Civilians.

Health and Wellness Questionnaire

Prior to all initial assessments, and again every 30 days, a Health and Wellness Questionnaire must be completed on any CAC enabled computer, the link can be found here, AFWC Pre-test instructions guidelines PDF. If CAC access is not available, a hard copy document will be provided; please arrive 10-15 minutes early to complete the questionnaire.

Services Available at the AFWC

The AFWC approach is holistic. Our staff members consider all the individual's physical, psychological, and social circumstances when providing health coaching. A holistic approach is important because a person's health cannot be fully addressed unless we consider the whole person.

Our Health Educators deliver primary prevention programs that will help you create and meet your health and wellness goals. You set the goals; the AFWC staff puts you on the path to achieving those goals and they walk the path with you!

The best part is… AFWC services do not cost YOU anything!

These services would cost you upwards of $3,000+ at a fitness center or civilian provider, so take advantage and schedule an appointment today!

Pre-test guidelines

Body composition analysis, metabolic assessments, and fitness assessments require you to follow specific guidelines prior to testing. A lack of preparation and not following the pre-test guidelines may cause inaccurate test results, therefore, appointments will need to be rescheduled for those not following the instructions and preparation guidelines found here, AFWC Pre-test instructions guidelines PDF.

Body composition analysis

Body composition goes beyond the number you see on the scale. Body Composition analysis determines how much of your weight comes from fat mass and fat-free mass. Fat-free mass includes everything the body is made of that is not fat, such as muscle, bone, bodily fluids, etc. This ultimately will tell you your body fat percentage and help you thoroughly track progress over time.

Metabolic Assessment

A Metabolic Assessment measures your resting metabolic rate (RMR), which is the number of calories you expend at rest in a 24-hour period. Your measured RMR is then used to more accurately estimate how many calories you need to consume and/or expend each day in order to lose, maintain or gain weight.

Fitness Assessment

Using state-of-the-art equipment, the AFWC can assess strength, physical fitness levels, and cardiorespiratory health through VO2 testing. This information can then be used to create an individualized exercise program.

Stress Management/Biofeedback

Health Educators provide you with education in biofeedback, stress relief techniques, and positive coping skills. Biofeedback is a relaxation technique used to teach clients to control functions like heart rate to reduce stress, reduce the physiological symptoms of stress, and build resilience.
Health Coaching for healthy nutrition, exercise prescription, etc.

This service includes one-on-one time to talk with our Health Educators! Health Educators will provide targeted education that will help you achieve your health and wellness goals. They will work closely with you and help you set realistic and actionable goals that are specific to you to help you achieve your health and wellness goals.

Classes

The AFWC provides classes on topics such as healthy nutrition, improving sleep hygiene, stress management, and performance optimization.
Unit level Briefs & Assessments
Leaders can contact the AFWC to schedule any of our classes and/or assessments for their unit.

Frequently Asked Questions

 - How to use the AFWC services?
There are three ways to be seen in the Wellness Center:
Referral by a healthcare provider
Referral by your unit
Self-referral
You can come in or call us directly at 913-758-3403 to schedule.

- Who can use the AFWC services?
All Military Healthy System/TRICARE beneficiaries and DOD/DA Civilian employees who are at least 18 years old are eligible to use AFWC services.
Active Duty
Retirees
Dependents
Children 17 and under MUST have a referral from a medical provider to use AFWC services
DOD/DA Civilians

- What if you PCS?
All visits are charted in your electronic medical record and in the Armed Forces Wellness Center secure web-based system. This means your record will follow you to your next duty station and you can pick up where you left off with your wellness plan.

- What if there is no AFWC at my duty station?
Virtual health coaching appointments are available by phone. Call any AFWC to schedule an appointment.

Late Policy

Clients who arrive more than 10 minutes late may be asked to reschedule. If you are unable to make your scheduled appointment, please call ahead to reschedule. The AFWC is an appointment-based center, and we make every effort to see our clients in a timely manner. It is strongly encouraged to arrive 10-15 minutes prior to your scheduled appointment to allow for completion of the Health and Wellness Questionnaire, if you have not filled it out prior to your appointment.

Cancellations

In order to provide the highest accessibility to our clients, please call to cancel appointments. Units may be notified of beneficiaries who demonstrate a pattern of failing to cancel appointments in a timely manner.

If you have any questions, or if you would like to schedule or cancel an appointment, please call 913-758-3403.