RESERVE COMPONENT MEDICAL HOLD SCREENING AND ASSIGNMENT

UNCLASSIFIED//

ROUTINE

R 090049Z APR 11

FM CNO WASHINGTON DC

TO AL NAVADMIN
NAVADMIN

INFO CNO WASHINGTON DC

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TO NAVADMIN
INFO CNO WASHINGTON DC//N1//
NAVADMIN 124/11

MSGID/GENADMIN/CNO WASHINGTON DC/N1/APR//

SUBJ/RESERVE COMPONENT MEDICAL HOLD SCREENING AND ASSIGNMENT//



REF/A/MSG/CNO WASHINGTON DC/291228ZFEB08//

REF/B/DOC/SECNAV/17MAR2006//

REF/C/DOC/SECNAV/30APR2002//

REF/D/MSG/CNO WASHINGTON DC/251335ZAPR05//

REF/E/DOC/OPNAV/25APR2006//

REF/F/DOC/NAVMED/12AUG2005//

REF/G/DOC/BUPERS/17SEP2007//

REF/H/DOC/U.S. CODE TITLE 10 - ARMED FORCES//

NARR/REF A IS NAVADMIN 056/08, RESERVE COMPONENT MEDICAL HOLD SCREENING AND 
ASSIGNMENT.
REF B IS SECNAVINST 1770.3D, MANAGEMENT AND DISPOSITION OF INCAPACITATION AND 
INCAPACITATION BENEFITS FOR MEMBERS OF THE NAVY AND MARINE CORPS RESERVE 
COMPONENTS.  REF C IS SECNAVINST 1850.4E, DON DISABILITY EVALUATION SYSTEM 
MANUAL.  REF D IS CNO MESSAGE WHICH ISSUED CHANGES TO THE LIMITED DUTY AND 
ASSIGNMENT SCREENING PROCESS.  REF E IS OPNAVINST 3060.7B, NAVY MANPOWER 
MOBILIZATION-DEMOBILIZATION GUIDE.  REF F IS MANUAL OF THE MEDICAL DEPARTMENT 
CHAPTER 18, MEDICAL EVALUATION BOARDS FROM THE BUREAU OF MEDICINE AND SURGERY 
MANUAL OF THE MEDICAL DEPARTMENT.  REF G IS BUPERSINST 1001.39F, 
ADMINISTRATIVE PROCEDURES FOR NAVY RESERVISTS.  REF H IS TITLE 10 OF THE 
UNITED STATES CODE WHICH OUTLINES THE ROLE OF ARMED FORCES THROUGHOUT THE 
UNITED STATES CODE.//

RMKS/1.  THIS NAVADMIN IS AN UPDATE TO REF A AND CLARIFIES THE RULES GOVERNING 
MANAGEMENT OF THE RESERVE COMPONENT (RC) PERSONNEL MEDICAL HOLD (MEDHOLD) 
SCREENING AND ASSIGNMENT PROGRAM.  COMNAVPERSCOM (PERS-95) IS THE BENEFITS 
ISSUING AUTHORITY
(BIA) FOR THE NAVY RC
MEDHOLD PROGRAM DESCRIBED IN REF B.

2.  MEDHOLD IS A SHORT-TERM MEDICAL TREATMENT PROGRAM FOR RESERVE COMPONENT 
SAILORS WITH THE SOLE PURPOSE OF ADDRESSING MEDICAL CONDITIONS INCURRED OR 
AGGRAVATED AFTER COMPLETION OF CONTINUOUS ACTIVE DUTY ORDERS FOR MORE THAN 30 
DAYS.
EVIDENCE MUST EXIST IN THE MEDICAL RECORD THAT A CONDITION WAS IDENTIFIED AND 
DOCUMENTED AFTER THE SAILOR COMPLETED 30 DAYS OF ACTIVE DUTY.  PER REF B, AND 
WITH THE MEMBER'S CONSENT, A MEMBER 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.

3.  PERSONNEL WILL NORMALLY BE LIMITED TO A TOTAL OF 12 MONTHS ON MEDHOLD IN 
PERIODS NO GREATER THAN 6 MONTHS. PERIODS EXCEEDING 12 MONTHS IN TOTAL 
DURATION REQUIRE COMNAVPERSCOM
PERS-95 APPROVAL AND WILL BE APPROVED ON A CASE-BY-CASE BASIS IF THE MEDICAL 
CONDITION WILL BE RESOLVED DURING AN ADDITIONAL 6 MONTH MEDHOLD PERIOD.  PER 
REF C, 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.

4.  THE MERE EXISTENCE OF AN ILLNESS, INJURY, OR DISEASE DOES NOT NECESSARILY 
QUALIFY A SAILOR FOR MEDHOLD.  THE CONDITION MUST RESULT IN THE SAILOR BEING 
UNFIT FOR DUTY.
SAILORS FOUND FIT FOR DUTY, PER REF B, WHO REQUIRE MEDICAL CARE FOR A MINOR OR 
CHRONIC CONDITION WILL BE MANAGED IAW BELOW PARA 5(A)(1).  CONTINUED TREATMENT 
FOR SUCH CONDITIONS MAY BE MANAGED USING THE SAILOR'S VETERANS AFFAIRS (VA), 
TRICARE BENEFITS, OR THE LINE OF DUTY (LOD) BENEFITS PROGRAM DESCRIBED IN REF 
B.

5.  PROCEDURES:
    A.  ONCE A MOBILIZED SERVICE MEMBER HAS BEEN DETERMINED TO
    HAVE A POTENTIALLY
UNFITTING MEDICAL CONDITION, THE SUPPORTING COMMAND SHALL IMMEDIATELY REQUEST 
DEMOBILIZATION ORDERS AND REQUEST PERS-4G TO TRANSFER MEMBER TO A NAVY 
MOBILIZATION PROCESSING SITE FOR FURTHER EVALUATION AND TREATMENT.  THE BIA 
SHALL PLACE A SERVICE MEMBER WITH AN IDENTIFIED INJURY OR ILLNESS ON MEDEVAL 
ORDERS FOR UP TO 90 DAYS FOR FURTHER MEDEVAL AND TREATMENT, WITH THE GOAL TO 
RETURN THE SAILOR TO FIT FOR DUTY STATUS AND RELEASE FROM ACTIVE DUTY OR MAKE 
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 IAW REF G FOR MEDICAL 
RETENTION REVIEW.
        (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 F.
            (B) THE MEDICAL BOARD CONVENING AUTHORITY AT
            THE MEDICAL
TREATMENT FACILITY (MTF) SHALL REVIEW AND, IF APPROPRIATE, APPROVE THE AMEBR.
            (C) THE MTF SHALL MAKE THE APPROPRIATE ENTRY
            INTO THE
MEDICAL BOARD ONLINE TRACKING SYSTEM (MEDBOLTS).
            (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) FOR MEMBERS PLACED INTO MEDHOLD THAT WERE
            SERVING ON MOBILIZATION ORDERS,
PERS-95 SHALL DIRECT PERS-4G TO INITIATE RC MEDHOLD ORDERS UNDER AUTHORITY OF 
SECTION 1
2301 (H) OF REF H.  AS STATED IN PARA 5 ABOVE, THE INITIAL MEDHOLD PERIOD 
SHALL NOT EXCEED 6 MONTHS.
            (G) FOR MEMBERS PLACED INTO MEDHOLD FROM NON
            -MOBILIZATION ORDERS, PERS-95 SHALL DIRECT NAVY RESERVE FORCES 
COMMAND(N31) TO INITIATE MEDHOLD ORDERS.  AS STATED IN PARA 3 ABOVE, THE 
INITIAL MEDHOLD PERIOD SHALL NOT EXCEED 6 MONTHS.  MEDHOLD UNITS WILL ENSURE 
REQUESTS FOR EXTENSIONS FOR ADT ORDERS WILL BE FORWARDED TO
PERS-95 NLT 30 DAYS
PRIOR TO END OF ORDERS TO PREVENT LOSS OF MEMBER'S BENEFITS.
            (H) PERS-95 SHALL DIRECT THE RESPECTIVE ORDER
            WRITING AUTHORITY TO ASSIGN
OR TRANSFER THE SAILOR TO A MEDHOLD 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 C.  THE PERIOD OF ORDERS SHALL BE GOVERNED BY THE ORDER 
WRITING SOURCE.
    B.  TRANSFER OF SAILOR:  AT ANY TIME DURING THE MEDHOLD
    PERIOD,
PERS-95 MAY DIRECT THE TRANSFER OF THE SAILOR TO THE MOST APPROPRIATE MEDHOLD 
UNIT FOR MEDICAL CARE. SAILORS TRANSFERRED OUTSIDE THE GEOGRAPHICAL AREA OF AN 
MTF SHALL HAVE A COMPLETED AMEBR AND UPDATED RECORD ENTRY INTO MEDBOLTS 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.
CONTINUED TREATMENT FOR CHRONIC CONDITIONS MAY BE MANAGED USING THE SAILORS 
VETERANS AFFAIRS (VA), TRICARE BENEFITS, OR THE LINE OF DUTY (LOD) BENEFITS 
PROGRAM DESCRIBED IN REF B.  THE FOLLOWING ACTIONS SHALL BE TAKEN:
        (1) THE TREATING PROVIDER SHALL MAKE THE APPROPRIATE
        ENTRY INTO THE SAILOR'S
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 B.
    D.  SECOND MEDHOLD PERIODS:  AT ANY TIME DURING THE FIRST 6
    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 5(A)(2), (A) THROUGH (E) ABOVE.
        (2) REQUESTS SHALL BE FORWARDED TO PERS-95 NLT 30
        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 THE ORDER
WRITING AUTHORITY TO MODIFY THE INITIAL MEDHOLD ORDERS TO EXTEND THE SAILOR ON 
MEDHOLD FOR UP TO AN ADDITIONAL 6 MONTHS FOR CONTINUED MEDICAL TREATMENT, NOT 
TO EXCEED 12 MONTHS FROM THE BEGINNING DATE OF THE FIRST PERIOD OF MEDHOLD.

6.  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 6 MONTH PERIOD OF 
MEDHOLD (NOT TO EXCEED
18 MONTHS OF MEDHOLD UNLESS IN THE PEB PROCESS), THE TREATING PROVIDER SHALL 
SUBMIT A COMPLETE, DICTATED MEDICAL EVALUATION BOARD REPORT (MEBR). REQUESTS 
SHALL BE FORWARDED TO PERS-95 NLT 60 DAYS IN ADVANCE OF THE END OF THE CURRENT 
PERIOD OF MEDHOLD TO AVOID A LAPSE IN THE MEMBER'S PAY AND BENEFITS.

7.  PEB PROCESS:
    A.  AS STATED IN REF F, "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 (REGARDLESS OF THE 
TIME SPENT ON MEDHOLD), THE TREATING PROVIDER SHALL RECOMMEND THE CASE BE 
REFERRED TO THE PEB FOR DISABILITY EVALUATION PER REFS C, D, AND F.  UPON 
INITIATION OF THE PEB PROCESS, THE MTF SHALL:
        (1) NOTIFY PERS-95;
        (2) FORWARD A COPY OF THE DICTATED MEBR TO PERS-95;
        AND
        (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.
MEDHOLD COMMANDS WILL ENSURE ORDER EXTENSION REQUESTS FOR MEMBERS REFERRED TO 
THE PEB WILL BE SUBMITTED AS STATED IN SECTION 6.
    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 SHALL BE 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 SHALL BE PROCESSED FOR SEPARATION AND RELEASED FROM 
MEDHOLD AFTER COMPLETION OF ADMINISTRATIVE REQUIREMENTS CONTAINED IN REF C.

8.  POINTS OF CONTACT:
    - PERS-95 DIRECTOR LOD/MEDHOLD/MRR DIVISION AND MEDICAL
    STATUS REVIEW
OFFICER, (901) 874-4280/DSN 882 OR VIA E-MAIL AT MEDHOLD(AT)NAVY.MIL.
    - PERS-95 MEDHOLD PROGRAM MANAGER, (901) 874-4212/DSN 882.
    - PERS-95 HEAD LOD/MRR BRANCH, (901) 874-4229/DSN 882.

9.  RELEASED BY VADM MARK FERGUSON, N1.//

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