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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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