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Military Physical Profile Serial System
The PULHES Factors
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To determine medical standards for different jobs, and to make sure that military members are medically qualified to perform the duties of that job, the military has developed a medical profile indicator, known as the physical profile serial system.

The physical profile serial system is based primarily upon the function of body systems and their relation to military duties. The functions of the various organs, systems, and integral parts of the body are considered. Since the analysis of the individual’s medical, physical, and mental status plays an important role in assignment and welfare, the military takes great care in executing the functional grading.

In developing the system, the functions have been considered under six factors designated “P–U–L–H–E–S.” Each of these letters stand for a specific medical area:

(1) P — The "P" in "P-U-L-H-E-S" stands for "Physical capacity or stamina." This factor, general physical capacity, normally includes conditions of the heart; respiratory system; gastrointestinal system, genitourinary system; nervous system; allergic, endocrine, metabolic and nutritional diseases; diseases of the blood and blood forming tissues; dental conditions; diseases of the breast, and other organic defects and diseases that do not fall under other specific factors of the system.

(2) U — The "U" area is used for "Upper extremities." This factor concerns the hands, arms, shoulder girdle, and upper spine (cervical, thoracic, and upper lumbar) in regard to strength, range of motion, and general efficiency.

(3) L — Lower extremities. This factor concerns the feet, legs, pelvic girdle, lower back musculature and lower spine (lower lumbar and sacral) in regard to strength, range of motion, and general efficiency.

(4) H — Hearing and ears. This factor concerns auditory acuity and disease and defects of the ear.

(5) E — Eyes. This factor concerns visual acuity and diseases and defects of the eye.

(6) S — Psychiatric. This factor concerns personality, emotional stability, and psychiatric diseases.

Four numerical designations are used to reflect different levels of functional capacity. The basic purpose of the physical profile serial is to provide an index to overall functional capacity. Therefore, the functional capacity of a particular organ or system of the body, RATHER THAN THE DEFECT PER SE, is evaluated in determining the numerical designation 1, 2, 3, or 4.

For example, if a military job requires a serial profile of "123123," that means, in order to qualify for that job, a person would have to be medically rated a "1" in the area of "Physical capacity or stamina," a medcial rating of "2" in the area of "Upper extremities," have a medical rating of "3" in the area of "Lower extremities," a rating of "1" in the area of "Hearing and Ears," etc.

As for the numerical designators, they generally mean a military medical evaluation of:

(1) An individual having a numerical designation of “1” under all factors is considered to possess a high level of medical fitness.

(2) A physical profile designator of “2” under any or all factors indicates that an individual possesses some medical condition or physical defect that may require some activity limitations.

(3) A profile containing one or more numerical designators of “3” signifies that the individual has one or more medical conditions or physical defects that may require significant limitations. For those applying for military service, this designation is usually a disqualification. For individuals already in the service, the individual should receive assignments commensurate with his or her physical capability for military duty (ie, limited duty/assignments)

(4) A profile serial containing one or more numerical designators of “4” indicates that the individual has one or more medical conditions or physical defects of such severity that performance of military duty must be drastically limited. Definately a disqualifier for both entering the military, and for continued military service, if already in the military.

Specific Definitions:

"P" Position - Physical capacity (First number in the profile series) - Organic defects, strength, stamina, agility, energy, muscular coordination, function, and similar factors.

1 - Good muscular development with ability to perform maximum effort for indefinite periods.

2 - Able to perform maximum effort over long periods.

3 - Unable to perform full effort except for brief or moderate periods.

4 - Functional level below the standards of "3."

"U" Position - Upper extremities (2nd number in the profile series) - Strength, range of motion, and general efficiency of upper arm, shoulder girdle, and upper back, including cervical and thoracic vertebrae.

1 - No loss of digits or limitation of motion; no demonstrable abnormality; able to do hand to hand fighting.

2 - Slightly limited mobility of joints, muscular weakness, or other musculo-skeletal defects that do not prevent hand–to–hand fighting and do not disqualify for prolonged effort.

3 - Defects or impairments that require significant restriction of use.

4 - Functional level below the standards of "3."

"L" Position - Lower extremities (3rd number in the profile series) - Strength, range of movement, and efficiency of feet, legs, lower back and pelvic girdle.

1 - No loss of digits or limitation of motion; no demonstrable abnormality; able to perform long marches, stand over long periods, run.

2 - Slightly limited mobility of joints, muscular weakness, or other musculo-skeletal defects that do not prevent moderate marching, climbing, timed walking, or prolonged effort.

3 - Defects or impairments that require significant restriction of use.

4 - Functional level below the standards of "3."

"H" Position - Hearing–ears (4th number in the profile series) - Auditory sensitivity and organic disease of the ears.

1 - Audiometer average level for each ear not more than 25 dB at 500, 1000, 2000 Hz with no individual level greater then 30 dB. Not over 45 dB at 4000 Hz.

2 - Audiometer average level for each ear at 500, 1000, 2000 Hz, or not more than 30 dB, with no individual level greater than 35 dB at these frequencies, and level not more than 55 dB at 4000 Hz; or audiometer level 30 dB at 500 Hz, 25 dB at 1000 and 2000 Hz, and 35 dB at 4000 Hz in better ear. (Poorer ear may be deaf.)

3 - Speech reception threshold in best ear not greater than 30 dB HL, measured with or without hearing aid; or acute or chronic ear disease.

4 - Functional level below the standards of "3."

"E" Position - Vision–eyes (5th number in the profile series) - Visual acuity, and organic disease of the eyes and lids.

1 - Uncorrected visual acuity 20/200 correctable to 20/ 20, in each eye.

2 - Distant visual acuity correctable to not worse than 20/40 and 20/70, or 20/30 and 20/100, or 20/20 and 20/ 400.

3 - Uncorrected distant visual acuity of any degree that is correctable not less than 20/40 in the better eye.

4 - Visual acuity below the standards of "3."

"S" Position - Type severity, and duration of the psychiatric symptoms or disorder existing at the time the profile is determined. Amount of external precipitating stress. Predisposition as determined by the basic personality makeup, intelligence, performance, and history of past psychiatric disorder impairment of functional capacity.

1 - No psychiatric pathology. May have history of a transient personality disorder.

2 - May have history of recovery from an acute psychotic reaction due to external or toxic causes unrelated to alcohol or drug addiction.

3 - Satisfactory remission from an acute psychotic or neurotic episode that permits utilization under specific conditions (assignment when outpatient psychiatric treatment is available or certain duties can be avoided).

4 - Does not meet standards of "3" above.

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