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Medical Boards and Overseas Suitability Screening for Providers

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					 Duty Status Processing and
Overseas/Suitability Screening

   Overview for the Busy Provider
   Duty Status Processing and
Overseas/ Suitability Screening for
            Providers
   Significant Recent Changes Affecting All
    Providers
   Goals of Presentation are:
       To Succinctly Review Changes
       Provide Overview of Reasons for Change but…
       Focus on Operational “nuts and bolts” Details
       Provide Resources for More In-Depth
        Review/Questions
                      Definitions
   Sick in Quarters (SIQ)
       Duty status assigned when service member is hurt/ill
        to the point that they are unable to perform any
        aspect of their job. Typically reserved for acute
        conditions requiring less than 72 hours to recover.
   Light Duty
       Duty status assigned when service member is hurt/ill
        but is able to safely perform some aspects of their
        job.
                      Definitions
   Convalescent Leave (CONLV)
       Duty status assigned when service member is hurt/ill
        to the point that they are unable to perform any
        aspect of their job. Can be prescribed for longer
        periods than SIQ, up to 30 days (postpartum – 42
        days).
   Limited Duty (LIMDU)
       Duty status assigned when service member is hurt/ill
        but is able to safely perform some aspects of their
        job. Can be prescribed for periods of time greater
        than light duty. Affects ability to receive/execute
        orders and other personnel functions.
                       Definitions
   Full Duty
       Duty Status assigned when, in the provider‟s opinion,
        the service member does not have a medical
        condition that interferes with successful and safe job
        performance.
   Fit For Continued Naval Service
       Finding of the PEB that a service member does not
        have a medical condition that constitutes a disability.
        The member may have duty limitations.
                      Definitions
   Unfit
       Finding of the PEB that a service member‟s condition
        constitutes a disability and the member should be
        separated/retired from active service.
   Fit for Duty
       Term used by a provider or medical board to describe
        a service member‟s condition that does not meet the
        definition of disability. Frequently used at the
        conclusion of a light or limited duty period or to
        explain why a service member‟s case is NOT being
        referred to the PEB.
                      Definitions
   Medical Evaluation Board (Med Board)
        A group (typically 2) of providers at an MTF that
        evaluates the medical status of a service member
        with a serious or protracted illness or injury.
   Medical Evaluation Board Report
       The document(s) that a Medical Evaluation Board
        produces. It may include a “Short Form” or
        Dictated/Long Form. These may be sent to other
        groups such as the Physical Evaluation Board or Naval
        Personnel Command.
                      Definitions
   Physical Evaluation Board (PEB)
       Group of Line Officers and Medical Officers at the
        Washington Navy Yard that evaluates the medical
        status of a service member with a serious or
        protracted illness/injury that appears to permanently
        limit the member‟s ability to do his job.
   Physical Evaluation Board Report
       Report issued by PEB that describes the Board‟s
        findings, includes a Naval disability rating.
                      Definitions
   Suitability/Overseas Screening
       Review of a service member‟s (and family‟s) medical
        status to determine if the member CAN EXECUTE a
        specific set of orders. Member must have “orders in
        hand.”
   Assignment Screening
       Review of a service member‟s medical status at the
        conclusion of a LIMDU or PEB process, conducted
        BEFORE the member has orders to determine what
        platform/location limitations might still exist.
            Duty Status Processing…
                 the “Old Way”
   SIQ
       Up to 72 hours
       Completely „excused‟ from work place
   Convalescent Leave (CONLV)
       Up to 30 days (42 postpartum)
       Completely „excused‟ from work place
       Command had options regarding travel/recuperation at place
        remote from command
   Light Duty
       Service Member reports to work place but with activity
        restrictions
       Max 30 days
       No inclusion of CONLV
           Duty Status Processing…
            the “Old Way” (cont.)
   Limited Duty (LIMDU)
       Done when prolonged (more than 30 days will
        have elapsed) work place activity restrictions
        were expected.
       Paperwork initially done by provider with
        referral to MTF medical board/convening
        authority.
       Enlisted and officer LIMDU handled differently
        at every level.
            Duty Status Processing…
             the “Old Way” (cont.)
   LIMDU- (Enlisted)
       Initial report done on „short form‟ and routed through MTF and
        PSD
       Maximum time of 8 months
       First and second periods of LIMDU could be approved at MTF
       Additional periods required dictated report (even if first period
        less than 8 months)
       So… vast majority of initial board reports prescribed for 8
        months
       Third or more periods routed to NPC for approval
       Prior to conclusion of LIMDU local PSD responsible for getting
        the service member a “re-evaluation” appointment at MTF
           Duty Status Processing…
            the “Old Way” (cont.)
   LIMDU- (Officer)
       Initial and all subsequent board reports
        required dictation
       Require PSD and MTF communication
       Approval of all LIMDU periods done at NPC
       Limited to 8 month periods
       Prior to conclusion of LIMDU local PSD
        responsible for getting the service member a
        “re-evaluation” appointment at MTF
           Duty Status Processing…
            the “Old Way” (cont.)
   PEB referral
       Done when service member‟s condition
        permanently affects their ability to perform
        their job
       Can happen at any time during service
        member‟s care… but condition should be
        stabilized
       PRT problems alone NOT appropriate for
        referral
        So Why Change NOW?
   Make time frames more consistent with
    known healing/recovery times
   Get PSD out of the business of making
    medical appointments
   Reduce provider paperwork/effort
   Simplify the process which will improve
    ownership and accountability throughout
    the member‟s chain of command and MTF
        Duty Status Processing…
            the “New Way”
   SIQ- no changes
   Convalescent leave- no changes
           Duty Status Processing…
               the “New Way”
   Light Duty
       No change in definition
       May be used for up to 90 days from the time member
        first gets ill/hurt, in increments up to 30 days
       Should only be used if provider reasonably expects
        member to return to medically unrestricted duty prior
        to the 90 day maximum
       CONLV is included in the 90 day limit
              Duty Status Processing
             … the “New Way” (cont.)
   LIMDU (Enlisted)
       “Short Form” may be used to document the first and
        second limited duty periods
       Maximum time for each period is 6 months
       Member is placed LIMDU at the same time a provider
        initiates a PEB referral if not already on LIMDU.
        (LIMDU paperwork notifies PSD of assignment
        limitations during PEB processing.)
       Third (or more) periods require BUPERS approval
       The third (or more) period of LIMDU in a member‟s
        career requires BUPERS approval and:
            If related to previous condition – dictation
            If unrelated to previous condition – short form
              Duty Status Processing
             … the “New Way” (cont.)
   LIMDU (Officer)
       Now LIMDU process is the SAME as Enlisted
        LIMDU EXCEPT:
            All LIMDU periods require BUPERS approval
LIMDU “Short Form”
    NAVMED 6100/5
         Suitability, Overseas and
          Assignment Screening
   These are medical evaluations done to aid
    NPC in appropriately issuing orders service
    members (and their families).

   Ultimately the final decisions regarding
    assignment are done at the GAINING
    command in conjunction with
    NPC/detailing.
Suitability and Overseas Screening
          … the “Old Way”
   Screening performed after receipt of orders
       Provider evaluated member‟s ability to safely execute
        orders to a specific location
       Provider evaluated family‟s ability to safely execute
        orders to a specific location
       NAVMED 1300/2 used to document findings
       If “qualified” no further action, if “not qualified”
        poorly defined process involving query of gaining
        command ensued
       Results sent to BUPERS/PSD for further processing
Suitability and Overseas Screening
          … the “New Way”
   Screening performed after receipt of orders
       Provider evaluates member‟s and family‟s ability to
        safely execute orders
       Results documented on NAVMED 1300/1
       If “qualified” no further action necessary… results
        sent to PSD
       If “not qualified” BUPERS medical provider (newly
        created position) will determine where to send
        member and family
       Minor changes made to specific testing areas (for
        example Pap smear timing) but overall screening
        process largely unchanged
              Assignment Screening
                … the “Old Way”
   Screening after completion of LIMDU/PEB
       Performed prior to issuance of orders
       Provider evaluated member‟s residual limitations
        which might have affected assignability
       NAVMED 1300/2 required medical input that was
        impossible to answer without orders in hand
       Family members not screened
       Best results were achieved if provider was able to
        recommend specific and appropriate operational or
        platform assignments. However, most providers were
        not knowledgeable enough to make such
        recommendations.
             Assignment Screening
               … the “New Way”
   Screening after completion of LIMDU/PEB
       Performed prior to issuance of orders
       Provider evaluates member‟s residual limitations
        which might affect assignability
       NEW form (NAVMED 1300/3) includes only a few
        questions that any provider can answer easily
       Screening prompts only the finding of “worldwide
        assignable” or a list of limitations
       If “world wide assignable,” no further action
        necessary… results sent to BUPERS
       If “not world wide assignable,” BUPERS medical
        provider will determine where to send member
SUITABILITY/OVERSEAS
     SCREENING
     NAVMED 1300/1
ASSIGNMENT SCREENING
      NAVMED 1300/3
                     Resources

   Manual of the Medical Department
    Chapter 18 effective date 10 Jan 2005
       http://www.vnh.org/Admin/MMD/001Contents.html
   BUMEDINST 1300.2 (series)
   Disability Evaluation Manual (SECNAVINST
    1850.4 series)
           SUMMARY

The following slides summarize the
major changes previously reviewed in
            greater detail
                        Changes
   OLD                          New
       Light duty 30 days           Light duty up to 90 days
        max                           in 30 day increments
                                      (including CONLEAVE)
                                     LIMDU 6 month
       LIMDU 8 month                 increments
        increments                   More than 12 months
       More than 16 months           requires NMPC waiver or
        goes to PEB                   PEB
                           Changes
   Old                                  New
       Members ending LIMDU                 Member ending LIMDU,
        get orders then operational           assignment screening done
        screen to see if fit for             Report goes to PERS and
        orders                                reviewed by assignment
       Screener comments on                  physician
        past illness                         PERS finds gaining
       Ship queries MTF, then                command before orders
        declines                              written
       PERS seeks an accepting              If no gaining command
        SMO                                   found, current command
       Member in limbo, billet               ADSEPs
        gapped
       If no gaining command
        found, current command
        ADSEPs
                        Changes
   Old                              New
       Some, not all ships              Central physician at
        decline PAP smear                 PERS can negotiate a
        abnormalities                     more consistent
       Some ships, not all,              screening criteria with
        decline CPAP                      Fleets
       CVNs decline history of          PERS physician will
        emotional problems                deal with MTF
        BUT recommend those               screener and gaining
        individuals go to                 command vice ship
        AMPHIBs                           and MTF trying to
                                          contact each other
                        Changes
   Old                             New
       LIMDU tracked by PSD            Current command
        which is responsible             responsible for getting
        for getting member               LIMDU member back
        back for FU                      for timely
        appointment                      appointments
       Members lost to follow          BUPERS tracks
        up after PCSing on              Members to Mast for
        LIMDU.                           missing appointments

				
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posted:5/22/2010
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