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Military Medical Standards for Continued Service
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The following medical conditions could result in initiation of a Medical Evaluation Board (MEB), and could result in medical discharge:

Upper extremities

Amputation of part or parts of an upper extremity which results in impairment equivalent to the loss of use of a hand.

Joint ranges of motion which do not equal or exceed the following:

For shoulder:

Forward elevation to 90 degrees.

Abduction to 90 degrees.

For elbow:

Flexion to 100 degrees.

Extension to 45 degrees of flexion.

Chronic dislocation, when not reparable or when surgery is contraindicated.

Lower Extremities

Hip dislocation.

Amputation of a toe or toes which precludes the ability to run or walk without a perceptible limp or to perform duty in a satisfactory manner.

Any loss greater than specified above to include foot, leg, or thigh.


Hallux valgus when moderately severe, with exostosis or rigidity and pronounced symptoms, or severe with arthritic changes.

Pes planus, symptomatic, more than moderate with pronation on weight bearing which prevents the wearing of a military shoe, or when associated with trophic changes.

Talipes cavus when severe, with moderate discomfort on prolonged standing and walking, metatarsalgia, or which prevents the wearing of a military shoe.

Internal derangement of the knee.

Residual instability following remedial measures if more than moderate in degree or with recurring episodes of effusion or locking, resulting in frequent incapacitation.

If complicated by arthritis.

Joint Ranges of Motion. Motion which does not equal or exceed the measurements listed below:

Hip. Flexion to 90 degrees. Extension to 0 degrees.

Knee. Flexion to 90 degrees. Extension to 15 degrees.

Shortening of an extremity which exceeds 5 centimeters (2 inches).



Arthritis due to infection associated with persistent pain and marked loss of function, with Xray evidence, and documented history of recurrent incapacitation.

Arthritis due to trauma, when surgical treatment fails or is contraindicated and there is functional impairment of the involved joint so as to preclude satisfactory performance of duty.

Osteoarthritis, with severe symptoms associated with impairment of function, supported by Xray evidence and documented history of recurrent incapacity for prolonged periods.

Rheumatoid arthritis or rheumatoid myositis, with substantiated history of frequent incapacitating episodes supported by objective and subjective findings.

Chondromalacia or Osteochondritis dessicans. Severe, manifested by frequent joint effusion, more than moderate interference with function, or with severe residuals from surgery.


Malunion when, after appropriate treatment, there is severe malunion with marked deformity or more than moderate loss of function.

Nonunion when, after an appropriate healing period, the nonunion persists with severe loss of function.

Bone fusion defect when manifested by severe pain or loss of function.

Callus, excessive, following fracture, when functional impairment precludes satisfactory performance of duty and the callus does not respond to adequate treatment.


Arthroplasty, with severe pain, limitation of motion, and limitation of function, joint prosthesis or total joint replacement.

Bony or fibrous ankylosis, with severe pain involving major joints or spinal segments, or ankylosis in unfavorable positions or ankylosis with marked loss of function.

Contracture with marked loss of function and the condition is not remediable by surgery.

Loose bodies within a joint with marked functional impairment complicated by arthritis to such a degree as to preclude favorable results of treatment.

Muscles. Flaccid or spastic paralysis or loss of substance of one or more muscles, producing loss of function which precludes satisfactory performance of military duty.

Myotonia congenita, significantly symptomatic.

Osteitis deformans. Involvement of single or multiple bones with resultant deformities, or symptoms severely interfering with function.

Osteoarthropathy. Hypertrophic, secondary, with severe pain in one or multiple joints and with moderate loss of function.

Osteomyelitis, chronic. Recurrent episodes not responsive to treatment or involving the bone to a degree which interferes with stability and function.

Tendon transplant. Unsatisfactory restoration of function.

Above Information Derived from Air Force Instruction 148-23

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