When a military member has a medical condition (including mental health conditions) which renders them unfit to perform their required duties, they may be separated (or retired) from the military for medical reasons. The process to determine medical fitness for continued duty involves two boards -- One is called the Medical Evaluation Board (MEB), and the other is called the Physical Evaluation Board (PEB).
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. DoD Directive 1332.18, SEPARATION OR RETIREMENT FOR PHYSICAL DISABILITY, DoD Instruction 1332.38, PHYSICAL DISABILITY EVALUATION, and DoD Instruction 1332.39, APPLICATION OF THE VETERANS ADMINISTRATION SCHEDULE FOR RATING DISABILITIES,
set forth the policies and procedures implementing the statute.
While most MEB/PEB actions occur when a military member voluntarily presents him/herself at the Medical Treatment Facility (MTF) for medical care, commanders may, at any time, refer military members to the MTF for a mandatory medical examination, when they believe the member is unable to perform his/her military duties due to a medical condition. This examination may cause conduct of a MEB, which will be forwarded to the PEB when it finds that the member's medical condition falls below medical retention standards.
Physical or mental health problems that are incompatible with military duty or that result in disqualification from world-wide deployment for more than 12 months precipitate an Medical Evaluation Board (MEB). Medical boards are initiated by the Medical Treatment Facility (base medical facility), not the individual or the command. The medical board consists of active duty physicians (not involved in the care of the military member) who review the clinical case file and decide whether the individual should be returned to duty, or should be separated, using the published medical standards for continued military service.
If the MEB determines that the member has a medical condition which is incompatable with continued military service, they refer the case to a Physical Evaluation Board (PEB). The PEB is a formal fitness-for-duty and disability determination that may recommend one of the following:
- Return the member to duty (with or without assignment limitations, and or medical re-training)
- Place the member on the temporary disabled/retired list (TDRL)
- Separate the member from active duty, or
- Medically retire the member
The standard used by the PEB for determining fitness is whether the medical condition precludes the member from reasonably performing the duties of his or her office, grade, rank, or rating. Per DoD Instruction 1332.38, 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, however, may be used as a consideration in determining fitness.
These recommendations are forwarded to a central medical board and can be appealed by the member, who is permitted to have legal counsel at these hearings.
Four factors determine whether disposition is fit for duty, separation, permanent retirement, or temporary retirement: whether the member can perform in their MOS/AFSC/Rating (job); the rating percentage; the stability of the disabling condition; and years of Active Service (active duty days) in the case of pre-existing conditions.
Fit for Duty: The member is judged to be fit when he can reasonably perform the duties of his grade and military job. If the member is medically unfit to perform the duties of his/her current job, the PEB can recommend medical re-training into a job he/she will be medically qualified to perform.
Disability Rating Percentage. Once a determination of physical unfitness is made, the PEB is required by law to rate the disability using the Department of Veterans Affairs Schedule for Rating Disabilities. DoD Instruction 1332.39 modifies those provisions of the rating schedule inapplicable to the military and clarify rating guidance for specific conditions. Ratings can range from 0 to 100 percent rising in increments of 10.