A member may be removed from full military duty for an initial period of 30 days of light duty, which may be followed by two additional 30 day periods of light duty for the purpose of evaluation or treatment of a medical condition, when it’s believed the medical condition will be resolved.

If the member is unable to return to full military duty at the end of the light duty period(s), the member will be referred to a Medical Board for evaluation for placement on Temporary Limited Duty (TLD) or referral to the Integrated Disability Evaluation System (IDES).

The mere presence of a diagnosis is not synonymous with a disability.

Medical issues, which initially either didn’t warrant TLD or TLD was no longer determined to be an effective process to address the medical issue are referred to the IDES. ("those members presenting for medical care, whose physical or mental fitness to continue naval service is questionable")

There is much more to the overall military medical process than TLD. Our governing doctrines are drafted with the intent to adhere to applicable sections of law. Title 10 CH.61 Sec. 1200 –1221 is the section of law that addresses service members with medical issues.  Sec. 1216 specifies that the Secretary concerned (SECNAV) shall prescribe regulations to carry out this chapter within his department.  SECNAVINST 1850.4E Department of the Navy (DON) Disability Evaluation System is the prescribed regulation.

Via IDES, the Physical Evaluation Board (PEB) acts on behalf of the Secretary of the Navy to make determinations of fitness for duty for active and reserve members of the DON, entitlement to disability benefits, disability ratings, and disposition of cases referred.

Cases submitted to the IDES will also address other significant factors such as Line of Duty Investigation, Misconduct determinations.

A Line of Duty Investigation is an inquiry used to determine whether an injury or disease of a member performing military duty was incurred in a duty status; if not in a duty status, whether it was aggravated by military duty; and whether incurrence or aggravation was due to the member's intentional misconduct or willful negligence.

For purposes of disability entitlements, misconduct consists of Intentional Misconduct or Willful Neglect. Members are not entitled to entitlements if the physical disability resulted from the member's own intentional misconduct or willful neglect or was incurred while the member was in an unauthorized absence status.

Physical Evaluation Board Liaison Officers (PEBLOs) are a field representative of the PEB. They are assigned or appointed to duty at each Navy Military Treatment Facility (MTF). PEBLOs are the service member’s point of contact for DTAP briefings, PEB findings, and counseling on options. The PEBLO does not replace the chain of command’s responsibility for managing their personnel. The Command Deployability Coordinator must be communicating with the PEBLO’s.

Separation Physicals - In accordance with NAVMED P-117, a complete physical examination, including a dental examination, will be given to all members within 6 months of separation, with exception of personnel authorized for discharge in absentia or those members on appellate leave. Separation physicals will be conducted within 4 weeks after receipt of separation orders where applicable, and prior to transfer of members to be separated at an activity other than their duty station. Cases submitted to the IDES require a completed physical examination to have been conducted within 6 months of the date of the MEB report.

A physical examination should be scheduled immediately following notification to member to preclude undue delay in separation upon receipt of separation authority.

Any condition that appears to significantly interfere with performance of duties appropriate to a service member's, *office, grade, rank or rating, or situations as discussed below, will be considered for MEB evaluation.

• Significantly interfere with the reasonable fulfillment of the purpose of the individual's employment in the military service;
• May seriously compromise the health or well-being of the individual if he or she were to remain in the military service This may involve dependence on certain medications, appliances, severe dietary restrictions, or frequent special treatments, or a requirement for frequent clinical monitoring;
• May prejudice the best interests of the Government if the individual were to remain in the military service.

*Office, Grade, Rank, Or Rating, Military Occupational Specialty (MOS)

• Office. A position of duty, trust, authority to which an individual is appointed.
• Grade. A step or degree in a graduated scale of office or military rank that is established and designated as a grade by law or regulation (E-7, O-5, W-2).
• Rank. The order of precedence among members of the Armed Forces.
• Rating. The occupational fields prescribed for Sailors (BM, Boatswain’s Mate; DT, Dental Technician; etc.) or Primary Military Occupational Specialties (PMOS) prescribed for Marines (0311, Rifleman; 3531, Motor Vehicle Operator; etc). Does not include secondary specialties (NEC or SMOS)

Retirement Eligible – Mandatory or Voluntary and High Year Tenure (HYT) Guidance

Personnel in a TLD status and approaching mandatory HYT retirement, HYT transfer to Fleet Reserve, or HYT separation will only be retained on active duty if actually hospitalized as an in-patient, or if their case has been accepted by IDES for disability determination. Being seen as an out-patient or submitting a case to the IDES (without it having been accepted is not sufficient justification to retain member beyond their HYT date)  PERS-454 Senior Medical Officer will make this determination.

Any administrative processing approval resulting in administrative separation takes precedence over TLD. 

Temporary Limited Duty is a personnel and medical management program.  Remember that Temporary Limited Duty is a program, which a member is expected to be returned to duty.  Any separation authority takes precedence over a member in a TLD status.  

MTFs should discuss disability adjudication (if appropriate per SECNAVINST 1850.4E) for personnel on TLD that have an administrative separation authority against them.  Extensions of the separation date shown on the separation authority letter or message should be addressed to the source.  The separation authority has final decision in extending separation date.  MTFs should document a member's condition on appropriate medical forms prior to member separating. 

Additionally, once an MTF initiates a MEB on a member, the member completes required BUMED forms.  One of these forms requires the member to indicate if he/she is going through administrative separation processing.  At this point, if member is being processed through ADSEP proceedings, the MTF should decide if enrollment into IDES is required and start processing a MEB for that purpose.  

Starting 1 July 2006, Sailors that fail 3 PFAs within a 4-year period must be administratively separated.  Although the PEB takes precedence over any separation authority (except those separations that will separate a member with an other than honorable due to misconduct); the PEB must accept a MEB to take precedence of PFA or any other administrative separation.  Basically, if the member is being separated and the PEB has not accepted a MEB yet, then the administrative separation continues unless otherwise determined by PERS-454 SMO.

A member cannot be separated if member is hospitalized as an in-patient.  

Communication is key...MTFs, commands, and PSDs should all communicate in what is best for the member. 

Presumed Fit (PFIT) - MEBs submitted on members who are pending retirement or who is retirement eligible enter the disability evaluation system under a rebuttal presumption that they are physically fit.

Members with over 20 years of active service shall not be continued on active duty solely to increase their monetary benefits, nor shall they be continued unless their employment is justified as being of value to the naval service.

Use of Earned Leave

·         Commands with a member who has a Medical Board report accepted by the IDES shall make every effort to accommodate leave requests of members physically able to do so. The command authorizing leave will notify the cognizant PEBLO of the inclusive dates and the member's leave address and phone number. Commands shall recall the member if required by the PEB President.

·         Commands need to be aware of the accounting status of a member’s leave. How many days of leave may be sold back? How many days of leave are on the books? If a Disability separation is directed they will normally occur within 4 – 6 weeks after the member’s election. Members should be encouraged to use their earned leave, especially leave that would be lost upon separation.

·         Members who have earned leave which they are unable to sell upon disability separation or retirement shall be permitted to use the additional leave before their separation date.

·         Commands shall not charge annual leave to members required reporting for examination, medical treatment, rehabilitation, therapy, etc., or when convalescent leave is the proper category of absence.

Processing for punitive discharge and processing for administrative discharge for misconduct takes precedence over processing for disability. The PEB will reject all cases in which the member is being processed for misconduct, which could result in the member receiving either a punitive or administrative discharge due to that misconduct.

It is the command’s responsibility to ensure that notification of administrative processing is made and communicated to the PEB for cases already being considered. Once the PEB is formally notified that punitive action has been initiated, disability case processing is immediately suspended pending the outcome of the punitive action.

When a punitive discharge or administrative discharge for misconduct does not result, disability processing shall be resumed and completed.

Non-misconduct/Non-Under Other Than Honorable (UOTH) administrative separations do not supersede or preclude disability separation. Consequently, final closure must occur on all disability processing/appeals prior to finalization of Non-misconduct/Non-UOTH administrative separation by field commanders/service headquarters.  Disability separation will take precedence in these cases.  If the member is found FIT by PEB then ADSEP may proceed.

A member may be determined Unfit as a result of the overall effect of two or more impairments even though each of them, standing alone, would not cause the member to be referred into the IDES or be found Unfit because of physical disability.

A service member may waive entrance into the IDES as specified in SECNAV INST. 1850.4E, subject to the approval of the PEB, acting on behalf of the Secretary of the Navy.

A member that requests a waiver of disability evaluation processing must complete a waiver memo.  A waiver is not granted until approved by the PEB.

The PEB notifies service headquarters of members found Unfit to continue naval service in order to separate or retire them as applicable.

"Unfit" is a finding by the PEB that the member is Unfit to continue naval service based on evidence which establishes that the member is unable to reasonably perform the duties of his or her office, grade, rank or rating

A member who has been found Fit to continue naval service or Physically Qualified for continued naval service from the review of the Informal PEB has no right to a Formal PEB hearing or a Petition for Relief by DIRNCPB.

The effective date of retirement/separation because of physical disability (either permanent or temporary) normally shall be within 4-6 weeks, on the average, after issuance of the "Notification of Decision." The 4-6 weeks average elapsed time standard is a guideline not an inflexible rule. It may be exceeded by Pers-821 in such circumstances as severe hardship on the member, taking earned leave when the member is unable to sell it, infeasibility, such as when there is longer lead-time for properly vacating government quarters or arranging movement of household effects, and adverse effect on the service such as when it would preclude contact relief of officers in command or other key billets.

Web address to Title 10, U.S. Code 61 law http://assembler.law.cornell.edu/uscode/html/uscode10/usc_sup_01_10_10_A_20_II_30_61.html

1201. Regulars and members on active duty for more than 30 days: retirement

1202. Regulars and members on active duty for more than 30 days: temporary disability retired list

1203. Regulars and members on active duty for more than 30 days: separation

1204. Members on active duty for 30 days or less or on inactive-duty training: retirement

1205. Members on active duty for 30 days or less: temporary disability retired list

1206. Members on active duty for 30 days or less or on inactive-duty training: separation

1207. Disability from intentional misconduct or willful neglect: separation

1207a. Members with over eight years of active service: eligibility for disability retirement for pre-existing conditions

1208. Computation of service

1212. Disability severance pay

1214. Right to full and fair hearing

1215. Members other than Regulars: applicability of laws

1216. Secretaries: powers, functions, and duties

1218. Discharge or release from active duty: claims for compensation, pension, or hospitalization

1219. Statement of origin of disease or injury: limitations

1221. Effective date of retirement or placement of name on temporary disability retired list