Abdominal and gastrointestinal defects and diseases 3-5
Gastrointestinal and abdominal surgery 3-6
Blood and blood-forming tissue diseases 3-7
Dental diseases and abnormalities of the jaws 3-8
Endocrine and metabolic disorders 3-11
Upper extremities 3-12
Lower extremities 3-13
Miscellaneous conditions of the extremities 3-14
Genitourinary system 3-17
Genitourinary and gynecological surgery 3-18
Vascular system 3-22
Miscellaneous cardiovascular conditions 3-23
Surgery and other invasive procedures involving the heart, pericardium, or vascular system 3-24
Trial of duty and profiling for cardiovascular conditions 3-25
Tuberculosis, pulmonary 3-26
Miscellaneous respiratory disorders 3-27
Surgery of the lungs 3-28
Mouth, esophagus, nose, pharynx, larynx, and trachea 3-29
Neurological disorders 3-30
Disorders with psychotic features 3-31
Mood disorders 3-32
Anxiety, somatoform, or dissociative disorders 3-33
Dementia and other cognitive disorders due to general medical condition 3-34
Personality, psychosexual conditions, transsexual, gender identity, exhibitionism, transvestism, voyeurism, other paraphilias, or factitious disorders; disorders of impulse control not elsewhere classified 3-35
Adjustment disorders 3-36
Eating disorders 3-37
Skin and cellular tissues 3-38
Spine, scapulae, ribs, and sacroiliac joints 3-39
Systemic diseases 3-40
General and miscellaneous conditions and defects 3-41
Malignant neoplasms 3-42
Benign neoplasms 3-43
Sexually transmitted diseases 3-44
Heat illness and injury 3-45
Cold injury 3-46
Medical Fitness Standards for Miscellaneous Purposes
5-14. Medical fitness standards for deployment and certain geographical areas
f. ... The following medical conditions must be reviewed carefully by the clinician before making a recommendation as to whether the Soldier can deploy to duty in a combat zone (or austere isolated area where medical treatment may not be readily available).
(1) Diabetes requiring insulin. ...
(2) Diabetes requiring oral medication for control. ...
(3) Cardiovascular conditions...the Soldier should not be deployed with any of the following conditions-
(a) Hypertension not controlled with medication.
(b) Recent episodes necessitating emergency room visits or closely monitored follow-up care.
(c) Permanent pacemakers, implanted antitachycardia and automatic implantable cardiac defibrillator (AICD) devices, ...
(d) Conditions requiring anticoagulants.
(e) Bare metal coronary stents. ...
(f) Drug eluting coronary stents. ...
(g) Closure device for patent foramen ovale or atrial septal defect. ...
(h) Cardiac arrhythmias. ...
(i) Smallpox vaccine associated myocarditis. ...
(4) Neurological conditions. Review paragraph 3-30 for profile guidance and MEB/PEB processing criteria.
(a) Seizure disorders. ...
(b) Demyelinating conditions...
(6) Sleep apnea...
(a) A psychiatric condition controlled by medication should not automatically lead to nondeployment. Soldiers with a psychiatric disorder in remission or whose residual symptoms do not impair duty performance may be considered for deployment duties. The commander makes the ultimate decision to deploy after consulting with the treating physician
or other privileged provider. The availability, accessibility, and practicality of a course of treatment or continuation of treatment in theater or austere environment should be consistent with clinical practice standards. If there are any questions on the safety of psychiatric medication, a psychiatrist must be consulted.
(b) Psychotic and bipolar disorders are considered disqualifying for deployment.
(c) Psychiatric disorders that meet medical retention standards must demonstrate a pattern of stability without significant symptoms for at least 3 months prior to deployment.
(d) Soldiers must demonstrate behavioral stability and minimal potential for deterioration or recurrence of symptoms in a deployed, austere environment, to the extent this can be predicted. The potential for deterioration must be evaluated considering potential environmental demands and individual vulnerabilities.
(e) Medication disqualifying for deployment include—
1. Antipsychotics used to control psychotic, bipolar, and chronic insomnia symptoms; lithium and anticonvulsants to control bipolar symptoms;
2. Medications that require special storage considerations, for example, refrigeration;
3. Medications that require laboratory monitoring or special assessments, including lithium, anticonvulsants, and antipsychotics;
4. Medication prescribed within 3 months prior to deployment that has yet to demonstrate efficacy or be free of significant impairing side effects.
(f) Psychotropics clinically and operationally problematic during deployments include short half-life benzodiazepines and stimulants. Decisions to deploy personnel on such medications should be balanced with necessity for such medication in order to effectively function in a deployed setting, susceptibility to withdrawal symptoms, ability to
secure and procure controlled medications, and potential for medication abuse.
(9) History of exertional heat injuries...
(10) Pregnancy. Pregnant Soldiers will not deploy.
(11) History of cancer. ...
(12) Chronic infectious diseases (HIV, Hepatitis B or C) ...
(13) Abnormal Cervical Cytology. ...
(14) Malignant hyperthermia. ...
(15) Contact lenses. ...
(16) Miscellaneous conditions. ...
(17) Medications. Soldiers taking medications should not automatically be disqualified for any duty assignment. Medications used for serious and/or complex medical conditions are not usually suitable for extended deployments. The medications on the list below are most likely to be used for serious and/or complex medical conditions that could likely
result in adverse health consequences...
(18) Dental. ...
7-4. Temporary vs. permanent profiles
b. Permanent profiles.
A profile is considered permanent unless a modifier of “T” (temporary) is added. A permanent profile may only be awarded or changed by the authority designated in paragraph 7–6, below. All
permanent “3” and “4” profiles, for Soldiers on active duty, will be reviewed by an MEB physician or physician approval authority. An MEB physician is an MTF dedicated subject matter expert trained to perform disability evaluations per guidelines established in DODI 1332.38 (see AR 40–400 for MEB process). The MEB physician will
assist the MTF commander in educating profiling officers on current physical profiling regulation and policy guidance.
(1) If the profile is permanent, the profiling officer must assess if the Soldier meets the medical retention standards of chapter 3. Those Soldiers on active duty who do not meet the medical retention standards must be referred to an MEB as per chapter 3. (See paras 9–10 and 10–25, respectively, for disposition of USAR and ARNG Soldiers not on active duty who do not meet medical retention standards.)
(2) Soldiers who have one or more condition(s) that do not meet medical retention standards are referred to a MEB /PEB after attaining the Medical Retention Determination Point (MRDP). The MRDP is when the Soldier’s progress appears to have medically stabilized; the course of further recovery is relatively predictable; and where it can be reasonably determined that the Soldier is most likely not capable of performing the duties required of his MOS, grade, or rank. This MRDP and referral to a MEB/PEB will be made within 1 year of being diagnosed with a medical condition(s) that does not appear to meet medical retention standards, but the referral may be earlier if the medical provider determines that the Soldier will not be capable of returning to duty within 1 year. The MEB physician or physician approval authority will review all MEB referrals to insure that MRDP has been achieved prior to initiating a
medical evaluation board; coordinate inappropriate MEB referrals back through the profiling officer for appropriate disposition; and assist physician approving authorities in reconciling profiling officer’s questions and concerns about MRDP timing and MMRB versus MEB referrals. The MEB physician or physician approval authority will review all profiles to confirm that the MRDP has been reached before obtaining the approving authority signature.
(3) Those Soldiers (active duty and USAR/ARNG) who meet retention standards but have at least a 3 or 4 PULHES serial will be referred to a Medical MOS Retention Board (MMRB) in accordance with AR 600–60, unless waived by the MMRB convening authority.
(4) Permanent profiles may be amended (following the correct procedure) at any time if clinically indicated and will automatically be reviewed and verified by the privileged provider at the time of a Soldier’s periodic health assessment or other medical examination.
(5) The Soldier’s commander may also request a review of a permanent profile, in accordance with paragraph 7–12b.
c. Temporary profiles.
Soldiers receiving medical or surgical care or recovering from illness, injury, or surgery, will be managed with temporary physical profiles until they reach the point in their evaluation, recovery, or rehabilitation where the profiling officer determines that MRDP has been achieved but no longer than 12 months. A temporary
profile is given if the condition is considered temporary, the correction or treatment of the condition is medically advisable, and correction usually will result in a higher physical capacity. Soldiers on active duty and RC Soldiers not on active duty with a temporary profile will be medically evaluated at least once every 3 months at which time the profile may be extended for a maximum of 6 months from the initial profile start date by the profiling officer.
(1) Temporary profiles exceeding 6 months duration, for the same medical condition, will be referred to a specialist (for that medical condition) for management and consideration for one of the following actions:
(a) Continuation of a temporary profile for a maximum of 12 months from the initial profile start date;
(b) Change the temporary profile to a permanent profile;
(c) Determination of whether the Soldier meets the medical retention standards of chapter 3 and, if not, referral to an
(2) The profiling officer must review previous profiles before making a decision to extend a temporary profile and refer the Soldier to a medical specialist for management if the temporary profile has been in effect for 6 months. Any extension of a temporary profile must be recorded on DA Form 3349, and if renewed, item 8 on the DA Form 3349 will contain the following statement: "This temporary profile is an extension of a temporary profile first issued on (date)."
(3) Temporary profiles will specify an expiration date. If no date is specified, the profile will automatically expire at the end of 30 days from issuance of the profile. In no case will Soldiers carry a temporary profile that has been extended for more than 12 months. If a profile is needed beyond the 12 months, the temporary profile will be changed to a permanent profile. Exceptions to the 12-month temporary physical profile restriction must be approved by the
medical treatment facility (MTF) commander or their designated senior physician approval authority (often the deputy commander for clinical services).
Army National Guard
10-15. Duty restrictions
a. Any recommendation for restricted activity that has been made by a private physician will be reported in writing, before performing any duty.
b. It is the individual Soldier's responsibility to report any medical problems immediately to the chain of command and to comply with medical restrictions. Commanders will honor the private physician's recommendations until the Soldier is evaluated by a military provider, and a recommended course of action is determined by a profiling officer (see para 7-6).
c. Soldiers and commanders will abide by the medical restrictions and limitations documented on any profile (DA Form 3349) issued.