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Army Medical Regulations

What is the MEB?

This information paper is designed to give you an overview of the Physical Disability Processing System. This system should not be confused with the MOS/Medical Retention Board (MMRB) process which is handled by G1/AG. Unlike the MMRB, disability processing does not include an option to reclassify.

Disability processing consists of four phases; the Clinical Work-Up (profile/physical examination), the Medical Evaluation Board (MEB), the Physical Evaluation Board (PEB), and review of the case by the Physical Disability Agency. Below is a brief explanation of each process. This information is by necessity of a general nature. You will be counseled during the board process and provided more specific information about your particular situation.

A. An MEB is a narrative summary of a soldier’s medical condition and a statement whether the soldier meets retention standards. A recommendation is also made regarding whether the case should be forwarded to the Physical Evaluation Board (PEB).

A. An MEB is initiated by the doctor when it is believed that a soldier’s condition is medically unacceptable for continued service in a soldier’s primary MOS, in accordance with AR 40-501, Chapter 3.

A. The soldier is referred to the Clinical Evaluation Coordinator located at the LaPointe Health Clinic. This begins the clinical work-up phase of the processing. The soldier is scheduled for an appointment to initiate processing and to complete the Phase I portion of the physical examination.  The soldier is referred to the Medical Boards Office, located in Rm 1AA13, Blanchfield Army Community Hospital where they are provided with a memorandum to take to their unit commander which notifies the unit of the disability processing and requests administrative documents be provided.  They meet with the counselor who will follow there case and any questions or concerns are answered. An appointment is given for the MEB Briefing which includes VA and ACAP transition counseling. At the time of this appointment, the administrative documents are reviewed by the counselor in the Medical Boards Office for completeness.

A. The Phase I physical consists of lab tests, chest x-ray, dental exam, and vision/hearing screening.  Once the results of the Phase I are received, the soldier is scheduled for the Phase II portion of the physical examination.

A. A Phase II physical is when the soldier sees a physician (or physician’s assistant) to review the soldier’s medical history and current medical condition.

A. Make sure that by the time you have all required documents when you come for the briefing appointment with the Medical Boards Office. This information is vital to your medical board and can hold up processing if not provided in a timely manner. In addition, please keep the Medical Boards Office and the Clinical Evaluation Coordinator notified of any change in your duty phone number or your home phone. Inability to contact the soldier can delay processing.

A. Soldiers may provide a Statement of Views to the physician for his review and consideration prior to dictation. This statement may provide any information the soldier feels is pertinent to his case and should be given to the Clinical Evaluation Coordinator prior to dictation of the narrative summary.

A. Once the Phase II is completed, the soldier is scheduled for an appointment with the physician who initiated the MEB for dictation of the Narrative Summary, or the packet is forwarded to the physician for dictation. This ends the clinical work-up phase of the processing.

- Dictation is transcribed in draft form and reviewed in the Medical Boards Office and sent to the physician for review. Upon completion of the physician’s review, the narrative summary is then transcribed in final format.

- Two doctors review and sign the MEB; the dictating physician, and another physician usually in the same specialty. The case is then forwarded to the Deputy Commander for Clinical Services for approval.

A. Once all signatures are obtained, a counseling appointment is made with an MEB counselor to allow the soldier to review and sign the MEB.

A. The soldier has the option to appeal the MEB at this point if the soldier feels there are significant discrepancies in the medical information.

A. The MEB, along with the health record, is mailed to the Physical Evaluation Board at Fort Sam Houston, TX where an informal board is convened.

A. The PEB is located at Ft. Sam Houston, TX, and consists of three members, one of which is a physician. The PEB will convene an informal board to review the MEB packet. A determination will be made regarding fitness and degree of disability.

Q. What are the PEB’s options?

- Separate without benefits (condition existed prior to service and was not permanently aggravated by service).

- Severance pay (0%, 10%, or 20%. Percentage relates to degree of severity).  Severance pay is a one-time lump sum payment made at the time of the soldier’s separation.

A. Soldier’s whose rating is at least 30% are placed on TDRL when their condition is considered unstable. A reexamination is required approximately every 18 months for a period not to exceed five years. Sometime during the five year period a permanent decision is made (i.e., fit for duty, severance pay, or permanent retirement). TDRL soldiers have all the privileges of a retiree, (PX, commissary, etc). Permanent Retirement (PDRL) provides a soldier with full privileges without requiring a periodic reexamination.

Q. What does it mean if the injury is “combat related”?

A. If the PEB finds the soldier unfit - the decision is also made whether the injury is considered “combat related”. It is not necessary for an injury to have occurred during direct combat to be considered combat related. Extra-hazardous duty, such as parachute jumps, rappelling, etc., can also be considered combat related. If the injury is considered to be combat related, there are advantages related to taxation of the severance pay or retirement.

A. It is figured at the following formula regardless of whether the rating was 0%, 10%, or 20%.  Keep in mind that the time used in the formula is active duty time only. It does not include any inactive time. The formula uses whole years. If you have less than six additional months of active time (i.e.; 5 years, 3 months) the time would be rounded down to five years. If you have more than six months additional active time (i.e.; 5 years, 8 months) the time would be rounded up to six years. The time is figured as of your last day of active duty. The maximum amount of time that can be used in the formula is 12. If you have more than 12 years of active duty service but less than 20, the formula will be done using 12.  2 X Base Pay X Number of Years Active Duty Service (Not to exceed 12)

A. The Severance Pay (along with any other pay due) is sent as an electronic fund transfer directly to your bank account 7-10 working days after your date of separation.

A. The soldier is contacted upon receipt of the findings from the PEB to set up an appointment for counseling.

- Nonconcur, with or without a written appeal. Soldiers found fit are not eligible to request a formal hearing.

- The case is forwarded to the Physical Disability Agency (PDA) for review. This is done whether the soldier requested a formal or concurred with the original findings (a more intensive review is done if the soldier nonconcurs with formal findings). PDA has the authority to change the findings from the PEB, but this does not happen very often. Once their review is completed, the case is forwarded for preparation of the message which authorizes separation.

- The soldier picks up the separation message, and the health record (if they have not already done so) from the Medical Boards Office. The soldier will then proceed to the Transition Point (Bldg 2577) where they will be given instructions regarding their orders and clearing papers. The health record, the VA Claim, a copy of the DA Form 199, and a copy of their orders are taken to a VA Representative in the Lee Soldier and Family Support Center, Bldg 5661, Screaming Eagle Blvd.

A. The PEB will review your appeal and provide a written response. If a change in the original findings is warranted, a new DA Form 199 will be provided. If not, a memorandum will be forwarded notifying you that no change was made and the case is forwarded to the Physical Disability Agency for their review.

A. If the soldier requests a Formal Hearing, the request is faxed to the PEB and a date for the formal hearing is obtained. The soldier is provided with a memorandum to take to their unit where TDY orders will be prepared to send the soldier to Ft. Sam Houston. The soldier arrives the day prior to the hearing to meet with an attorney, remains overnight, and attends the formal hearing the next day.  Uniform is Class A or B. Once the hearing is completed the board will make a decision and notify the soldier of the decision the same day. The soldier may concur with the decision, submit a rebuttal, or take ten days to decide.

A. If the soldier concurs with the formal findings, the case is processed as shown above. If a soldier nonconcurs, the case is again reviewed at the PEB and then forwarded to the Physical Disability Agency for their review. PDA has the authority to change the findings from the PEB. Once their review is completed, if no change is made, the case is forwarded for preparation of the message which authorizes separation. Processing then continues as shown above.

A. Permissive TDY is given to involuntarily separated soldiers to assist in preparing for the transition to civilian life.

A. Soldiers separating because of disability are generally eligible for 20 days of permissive TDY, however, this is not an entitlement. Approval of permissive TDY is a command decision.

Q. When can I take Permissive TDY?

A. Permissive TDY is designed to be taken once the soldier has received their separation date. The soldier can clear first, depart on permissive TDY, and not have to return to Fort Campbell. On the last day of permissive TDY, the Transition Point does the final processing and the DD Form 214 is mailed to the soldier.

A. Come to the Medical Boards Office where a memorandum will be prepared. The soldier is given samples of other documents which must be obtained (memorandum from the unit commander and affidavit from the soldier). These documents are then taken to the Medical Holding Company, Bldg 731 Mississippi Avenue. It is recommended that the soldier start the process to be extended approximately 45 days prior to the ETS.

A. Contact the Reassignments Section of G1/AG Generally, a copy of the permanent profile is required.

A. To be assigned to the Medical Holding Company requires the doctor’s recommendation and approval by the hospital Command Group. This is normally done when a soldier’s medical condition is of such severity that they are unable to perform any meaningful duty within the unit.

A. In accordance with AR 600-8-10, transition leave (formerly called terminal leave) can be granted only if the soldier can not cash in the leave. Soldiers can cash in up to 60 days during their career. If the soldier has never cashed in any leave and has less than 60 days of leave accrued, they can not take it as transition leave. The leave will be cashed in and paid shortly after separation. This applies whether you are receiving severance pay or a medical retirement. The soldier can apply to be approved to take leave as Transition Leave as an exception to policy. At the time the soldier is counseled regarding the PEB findings they can request this exception. A memorandum is prepared which is taken by the soldier to their chain of command. An endorsement from the unit from at least O-6 level recommending approval must be obtained. This is then returned to the Medical Boards Office for processing. The decision regarding approval is made by the Physical Disability Branch, WRAMC. Transition Leave will only be approved in extremely exceptional cases, where selling back the leave would cause undue hardship on the soldier or the soldier’s family.

A. Once the case is finalized at the Physical Evaluation Board, the health records are returned to the Medical Boards Office. The soldier can sign them out at that time. It is recommended that a copy of the records be made. Once separation orders are received, the soldier will take the health record, their VA Claim, and a copy of the PEB findings (DA Form 199) to the VA Representative. This is done on a walk-in basis. The VA will keep the records and provide the soldier with a statement to use when clearing.

A. The separation message will provide a “not later than” date approximately 90 days from the day the message is received. The installation commander, through the Transition Point, will establish a release date within this 90-day window. Soldiers will be separated or retired as expeditiously as possible. The intent of the 90-day window is to allow commanders the flexibility to deal with local command policies and procedures as well as unique family considerations. You must be separated or retired by the not later than date, however your date may be set at any time within the window.

A. Soldiers will be separated or retired at the highest grade successfully held. The soldier must provide documentation to the Medical Boards Office showing the highest grade held, along with the reason for the loss of grade. This information will be included in the MEB packet. At the time the separation/retirement date is set, the case will be forwarded by the Physical Disability Branch to the Grade Determination Board for a decision.

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