RESERVE COMPONENT MEDICAL HOLD SCREENING AND ASSIGNMENT NAVADMIN 056/08

RAAUZYUW RUEWMCS0000 0632015-UUUU--RUCRNAD
ZNR UUUUU
R 291228Z FEB 08
FM CNO WASHINGTON DC//N1//
TO NAVADMIN
INFO CNO WASHINGTON DC//N1//
UNCLAS //N01770//
NAVADMIN 056/08
MSGID/GENADMIN/CNO WASHINGTON DC/N1/FEB//
SUBJ/RESERVE COMPONENT MEDICAL HOLD SCREENING AND ASSIGNMENT//
REF/A/DOC/SECNAVINST 1770.3D/17MAR2006// REF/B/DOC/SECNAVINST
1850.4E/30APR2002// REF/C/RMG/CNO WASHINGTON DC/251335ZAPR05//
REF/D/DOC/OPNAVINST 3060.7B/25APR2006// REF/E/DOC/NAVMED P-117:  MANUAL
OF THE MEDICAL DEPARTMENT, CHAPTER 18/12AUG2005// REF/F/DOC/U.S. CODE
TITLE 10-ARMED FORCES//
NARR/REF A IS MANAGEMENT AND DISPOSITION OF INCAPACITATION AND
INCAPACITATION BENEFITS FOR MEMBERS OF THE NAVY AND MARINE CORPS
RESERVE COMPONENTS.  REF B IS DON DISABILITY EVALUATION SYSTEM MANUAL.
REF C ISSUED CHANGES TO THE LIMITED DUTY AND ASSIGNMENT SCREENING
PROCESS.  REF D IS NAVY MANPOWER MOBILIZATION-DEMOBILIZATION GUIDE.
REF E IS BUREAU OF MEDICINE AND SURGERY MANUAL OF MEDICAL DEPARTMENT.
TITLE 10 OF THE UNITED STATES CODE OUTLINES THE ROLE OF ARMED FORCES IN
THE UNITED STATES CODE.//
RMKS/1.  THIS NAVADMIN CLARIFIES THE RULES GOVERNING MANAGEMENT OF THE
RESERVE COMPONENT (RC) PERSONNEL MEDICAL HOLD (MEDHOLD) SCREENING AND
ASSIGNMENT PROGRAM.
2.  FOLLOWING THE ATTACKS OF SEPTEMBER 11, 2001, THE NAVY GREATLY
INCREASED THE NUMBER OF RC SAILORS ON ACTIVE DUTY.  AS A RESULT, WE SAW
AN INCREASE IN THE NUMBER OF RC SAILORS INCURRING/AGGRAVATING INJURIES
OR ILLNESSES WHILE ON ACTIVE DUTY.  IN TURN, THIS HAS LED TO A LARGER
NUMBER OF RC SAILORS RETAINED ON ACTIVE DUTY IN MEDHOLD FOR MEDICAL
EVALUATION (MEDEVAL) AND TREATMENT (REFS A THROUGH E APPLY).
3.  COMNAVPERSCOM (PERS-95) IS THE BENEFITS ISSUING AUTHORITY (BIA) FOR
THE NAVY RC MEDHOLD PROGRAM DESCRIBED IN REF A.
4.  MEDHOLD IS A SHORT-TERM MEDICAL TREATMENT PROGRAM FOR RESERVE
COMPONENT SAILORS TO ADDRESS CONDITIONS INCURRED OR AGGRAVATED DURING
PERIODS OF ACTIVE DUTY OF 30 DAYS OR MORE.  EVIDENCE MUST EXIST IN THE
MEDICAL RECORD THAT A CONDITION WAS IDENTIFIED AND DOCUMENTED WHILE THE
SAILOR WAS ON ACTIVE DUTY ORDERS OF 30 DAYS OR MORE.  IAW REF A, AND
WITH THE MEMBER’S CONSENT, MEMBERS MAY THEN BE ORDERED TO, OR CONTINUED
ON, ACTIVE DUTY TO COMPLETE FURTHER MEDICAL EVALUATION (MEDEVAL) AND TO
RECEIVE AUTHORIZED MEDICAL CARE UNDER THE MEDHOLD PROGRAM.
5.  PERSONNEL WILL BE LIMITED TO A TOTAL OF 12 MONTHS ON MEDHOLD IN
PERIODS NO GREATER THAN SIX MONTHS.  PERIODS EXCEEDING 12 MONTHS IN
TOTAL DURATION REQUIRE COMNAVPERSCOM APPROVAL AND WILL BE APPROVED ON A
CASE-BY-CASE BASIS IF THE MEDICAL CONDITION WILL BE RESOLVED DURING AN
ADDITIONAL SIX MONTH MEDHOLD PERIOD.  OTHERWISE, IAW REF B THE CASE
WILL BE ENTERED INTO THE DISABILITY EVALUATION SYSTEM (DES) AND THE
SAILOR WILL BE REFERRED TO THE PHYSICAL EVALUATION BOARD (PEB) FOR
DETERMINATION OF FITNESS TO CONTINUE NAVAL SERVICE, ENTITLEMENT TO
BENEFITS, DISABILITY RATINGS, AND DISPOSITION OF THE SERVICE MEMBER.
6.  THE MERE EXISTENCE OF AN ILLNESS, INJURY OR DISEASE DOES NOT
NECESSARILY QUALIFY A SAILOR FOR MEDHOLD.  THE CONDITION MUST RESULT IN
THE SAILOR NOT FIT FOR DUTY.  SAILORS FOUND FIT FOR DUTY, IAW REF A,
WHO REQUIRE MEDICAL CARE FOR A MINOR OR CHRONIC CONDITION MAY BE
RELEASED FROM MEDHOLD.  CONTINUED TREATMENT FOR SUCH CONDITIONS MAY BE
MANAGED USING THE SAILORS VETERAN AFFAIRS (VA) OR TRICARE BENEFITS, OR
THE LINE OF DUTY (LOD) BENEFITS PROGRAM DESCRIBED IN REF A.
7.  PROCEDURES:
A.  THE BIA SHALL PLACE A SERVICE MEMBER WITH AN IDENTIFIED INJURY
OR ILLNESS ON MEDEVAL ORDERS FOR UP TO 30 DAYS FOR FURTHER MEDEVAL AND
TREATMENT, WITH THE GOAL TO RETURN THE SAILOR TO FIT FOR DUTY STATUS,
AND RELEASE FROM ACTIVE DUTY OR AVAILABLE FOR REASSIGNMENT.  AT ANY
TIME DURING THE MEDEVAL PERIOD, THE TREATING PROVIDER MAY RECOMMEND TO
PERS-95 THAT THE SAILOR IS FIT FOR DUTY, OR IS UNFIT FOR DUTY AND
REQUIRES FURTHER MEDICAL CARE.  ONE OF THE FOLLOWING COURSES OF ACTION
SHALL BE TAKEN:
(1) IF FIT FOR DUTY, THE SAILOR SHALL BE IMMEDIATELY CLEARED
AND RETURNED TO A DUTY STATUS FOR COMPLETION OF ACTIVE DUTY ORDERS,
REASSIGNMENT, OR PROCESSING FOR RELEASE FROM ACTIVE DUTY.
(2) IF UNFIT FOR DUTY, THE FOLLOWING ACTIONS SHALL BE TAKEN:
(A) THE TREATING PROVIDER SHALL COMPLETE A NAVMED 6100/5,
ABBREVIATED MEDICAL EVALUATION BOARD REPORT (AMEBR) PER REF E.
(B) THE MEDICAL BOARD CONVENING AUTHORITY AT THE MEDICAL
TREATMENT FACILITY (MTF) SHALL REVIEW AND APPROVE THE AMEBR.
(C) THE MTF SHALL MAKE THE APPROPRIATE ENTRY INTO THE
MEDICAL BOARD ONLINE TRISERVICE TRACKING SYSTEM (MEDBOLTT).
(D) THE MTF SHALL FORWARD THE AMEBR TO PERS-95.
(E) PERS-95 WILL REVIEW THE RECOMMENDATION AND AUTHORIZE
PLACING THE SAILOR IN THE MEDHOLD PROGRAM.
(F) PERS-95 SHALL DIRECT PERS-4G TO INITIATE RC MEDHOLD
ORDERS UNDER AUTHORITY OF SECTION 12301 (H) OF REF F.  AS STATED IN
PARA 5 ABOVE, THE INITIAL MEDHOLD PERIOD SHALL NOT EXCEED SIX MONTHS.
(G) PERS-95 SHALL DIRECT PERS-4G TO ASSIGN OR TRANSFER THE
SAILOR TO A COMMAND FOR ADMINISTRATIVE MANAGEMENT, WITH THE GOAL OF
CONTINUED TREATMENT UNTIL THE SAILOR IS RETURNED TO ACTIVE DUTY,
RELEASED FROM ACTIVE DUTY, OR UNTIL FINAL DISPOSITION IS DETERMINED BY
THE PEB PER REF B.
B.  TRANSFER OF SAILOR:  AT ANY TIME DURING THE MEDHOLD PERIOD,
PERS-95 MAY DIRECT THE TRANSFER OF THE SAILOR TO THE MOST APPROPRIATE
COMMAND FOR MEDICAL CARE.  SAILORS TRANSFERRED OUTSIDE THE GEOGRAPHICAL
AREA OF AN MTF SHALL HAVE A COMPLETED AMEBR AND UPDATED RECORD ENTRY
INTO MEDBOLTT BY THE INITIATING MTF PRIOR TO TRANSFER.
C.  RELEASE FROM MEDHOLD:  THE TREATING PROVIDER MAY RECOMMEND THE
RELEASE OF A PATIENT FROM MEDHOLD AT ANY CLINICALLY APPROPRIATE TIME
DURING MEDHOLD.  THE FOLLOWING ACTIONS SHALL BE TAKEN:
(1) THE TREATING PROVIDER SHALL MAKE THE APPROPRIATE ENTRY INTO
THE SAILORS MEDICAL RECORD AND COMPLETE NAVMED 6100/6, RETURN OF A
PATIENT TO MEDICALLY UNRESTRICTED DUTY.
(2) THE MTF SHALL NOTIFY PERS-95 AND FORWARD A COPY OF THE
COMPLETED NAVMED 6100/6.
(3) UPON REVIEW AND APPROVAL OF THE RECOMMENDATION, THE
PERS-95 SENIOR MEDICAL OFFICER (SMO) AND/OR THE MEDICAL STATUS REVIEW
OFFICER (MSRO) SHALL RELEASE THE SAILOR FROM ACTIVE DUTY STATUS PER REF
A.
D.  SECOND MEDHOLD PERIODS:  AT ANY TIME DURING THE FIRST SIX MONTH
MEDHOLD PERIOD, IF THE TREATING PROVIDER DETERMINES THE SAILOR WILL
LIKELY NOT BE FOUND FIT FOR DUTY DURING THE FIRST PERIOD OF MEDHOLD,
BUT WILL LIKELY BE FOUND FIT FOR DUTY DURING A SECOND PERIOD OF MEDHOLD,
THE FOLLOWING ACTIONS SHALL BE TAKEN:
(1) THE PROVIDER SHALL REQUEST A SECOND PERIOD OF MEDHOLD BY
COMPLETING THE STEPS IN PARA 7A (2), (A) THROUGH (E) ABOVE.
(2) REQUESTS SHALL BE FORWARDED TO PERS-95 NLT 60 DAYS IN
ADVANCE OF THE END OF THE FIRST PERIOD OF MEDHOLD TO AVOID A LAPSE IN
THE MEMBERS PAY AND BENEFITS.
(3) UPON REVIEW AND APPROVAL OF THE AMEBR, PERS-95 SHALL DIRECT
PERS-4G TO MODIFY THE INITIAL MEDHOLD ORDERS TO EXTEND THE SAILOR ON
MEDHOLD FOR UP TO AN ADDITIONAL SIX MONTHS FOR CONTINUED MEDICAL
TREATMENT, NOT TO EXCEED 12 MONTHS FROM THE BEGINNING DATE OF THE FIRST
PERIOD OF MEDHOLD.
8.  ADDITIONAL MEDHOLD PERIODS BEYOND 12 MONTHS:  REQUESTS FOR PERIODS
OF MEDHOLD BEYOND A TOTAL OF 12 MONTHS WILL BE CONSIDERED BY PERS-95 IN
RARE INSTANCES ONLY ON A CASE-BY-CASE BASIS.  TO REQUEST A THIRD SIX
MONTH PERIOD OF MEDHOLD (NOT TO EXCEED 6 MONTHS) THE TREATING PROVIDER
SHALL SUBMIT A COMPLETE, DICTATED MEBR 60 DAYS IN ADVANCE TO PERS-95.
9.  PEB PROCESS:
A.  AS STATED IN REF E, "MEB AND MEBR OPERATIONS ARE SIGNIFICANT
AND VITAL COMPONENTS OF APPROPRIATE PATIENT CARE, AS WELL AS COMPELLING
READINESS ISSUES WHOSE APPROPRIATE EXECUTION SERVES AS A TANGIBLE FORCE
MULTIPLIER."  IF AT ANY TIME DURING THE RC MEDHOLD PROCESS, IT APPEARS
THE SAILOR WILL NOT BE FOUND FIT FOR DUTY WITHIN A REASONABLE TIME
BASED ON CONDITION, PROGRESS, AND BEST AVAILABLE MEDICAL EVIDENCE, (NO
MATTER THE TIME SPENT ON MEDHOLD) THE TREATING PROVIDER SHALL RECOMMEND
THE CASE BE REFERRED TO THE PEB FOR DISABILITY EVALUATION IAW REFS B, C
AND E.  UPON INITIATION OF THE PEB PROCESS, THE MTF SHALL:
(1) NOTIFY PERS-95.
(2) FORWARD A COPY OF THE DICTATED MEBR TO PERS-95.
(3) TRACK THE PROGRESS OF THE PEB AND NOTIFY PERS-95 OF ANY
SIGNIFICANT UPDATES TO THE SAILORS PEB PROCESS OR ISSUES THAT MAY DELAY
THE PROCESS.
B.  ONCE COMPLETED, THE PEB PROCESS MAY RESULT IN ONE OF TWO
FINDINGS:
(1)  IF THE PEB FINDS THE SAILOR "FIT FOR CONTINUED NAVAL
SERVICE", THE SAILOR IS RELEASED FROM MEDHOLD.  ANY FUTURE MEDICAL CARE
FOR IDENTIFIED CONDITIONS IS REFERRED TO OTHER PROGRAMS SUCH AS THE VA
HEALTHCARE SYSTEM AND TRICARE.
(2) IF THE PEB FINDS THE SAILOR "UNFIT FOR CONTINUED NAVAL
SERVICE", THE SAILOR IS RELEASED FROM MEDHOLD AND FURTHER PROCESSING OF
THE SAILOR FOLLOWS THE PROCEDURES CONTAINED IN REF B.
10.  POINTS OF CONTACT:
-PERS-95 DIRECTOR LOD/MEDHOLD/MRR DIVISION AND MEDICAL STATUS REVIEW
OFFICER, CAPT JIM TOWNSEND, (901) 874-4280/DSN 882 OR EMAIL AT
MEDHOLD(AT)NAVY.MIL.
-PERS-95 HEAD MEDHOLD BRANCH AND SENIOR MEDICAL OFFICER, CAPT LOUIS
TRIPOLI (MC), (901) 874-4202/DSN 882.
-PERS-95 HEAD LOD/MRR BRANCH, HMCM(AW/SW) KURT LEWIS,
(901) 874-4503/DSN 882.
11.  RELEASED BY VADM J. C. HARVEY, JR., N1.//

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