Understanding the Military Medical Evaluation Process

The military’s medical evaluation process is complex, and understanding it is sometimes overwhelming for service members and their families. The process begins when the service member is recommended for a medical board, usually by his or her treating physician. A final determination can be made in as little as 45 days – or much longer – depending on the complexity of the case. The Physical Evaluation Board Liaison Officer is the service member’s main liaison during the process, providing valuable guidance and serving as a patient advocate.

Medical boardA physician recommends a medical board when it becomes apparent that the service member’s condition may permanently interfere with his or her ability to serve on active duty. The Military Treatment Facility where the service member is receiving care assembles the medical board documents, which include the following:

  • Medical documentation. A current medical examination, a copy of the patient’s medical record, an assessment by a senior physician and approvals by two additional physicians are included as medical documentation.
  • Non-medical documentation. An assessment by the service member’s commanding officer describes how the member’s condition affects his or her ability to perform the assigned job duties. This assessment is important to the medical board, because, although a service member may have permanent disabilities, he or she still may be qualified for the job.
  • Optional rebuttal by the service member. If the service member disagrees with any of the information included in the medical board documents, he or she may submit a rebuttal, which is included in the documentation sent to the Physical Evaluation Board.

The medical board may recommend Temporary Limited Duty (normally for a period of not more than 12 months) and re-evaluate the case later. Otherwise, the medical board documents are forwarded to the PEB.

Physical Evaluation BoardThe Physical Evaluation Board reviews all medical board documentation to determine if the service member is fit for continued military service. The board looks at many factors, including the medical information, the service member’s rate or Military Occupational Specialty, and whether or not the member is deployable. The PEB must consider the medical condition and how it affects the service member’s ability to do his or her job. The determination and subsequent disability rating assigned by the PEB are based on the member’s ability to perform his or her duties. The following steps take place during a PEB:

  • Informal Board – After reviewing the documentation, the board determines whether or not the service member is fit for duty. If found unfit, the board will assign a disability rating. If the rating is less than 20 percent, the service member may be discharged with or without the benefit of severance pay. If the rating is more than 30 percent, the board may place the service member on one of the following:
    • Temporary Disability Retired List (TDRL) – The service member may stay on the TDRL for up to five years, but must be re-evaluated every 12 to 18 months. While on TDRL, he or she receives retired pay and is entitled to retiree benefits.
    • Permanent Disability Retired List (PDRL) – On PDRL, the service member receives retirement pay and benefits for life.
  • Service member’s review – The PEB Liaison Officer advises the service member on the Informal Board’s findings. If the service member disagrees with the findings, he or she may request a Formal Board. Members found not fit for duty have the right to demand a Formal Board.
  • Formal Board – An attorney is appointed to represent the service member (or the member may hire an attorney) at the Formal Board. The Formal Board re-examines the evidence, hears testimony and considers any new evidence before making its recommendation. The Formal Board may uphold the Informal Board’s recommendations or make a new determination.
  • Continuing on active duty – Service members found unfit for duty may submit a request to continue on active duty. These requests are included with the PEB documentation when it is forwarded to the service headquarters for a final decision. The procedures vary depending on the branch or service:
    • Army – Soldiers may submit a Continuation of Active Duty request. Requests are most often granted for soldiers with 15 to 20 years of active service or soldiers with critical job skills.
    • Marine Corps and Navy – Marines and sailors may submit a request for Permanent Limited Duty. These requests are most often granted to members with 18 to 20 years of service or those who can fill a critical billet.
  • Final decision – The informal or formal PEB recommendations, and any request for COAD or PLD, are sent to the member’s service headquarters. The headquarters makes the final determination on both the medical board’s recommendations and the COAD or PLD request. Whatever the outcome, PEBLOs are on hand at most MTFs to assist the service member and family through the process.