REFERENCE SECTIONS:

OTSG / MEDCOM

Warrior in Transition (WT) – RC SOLDIER’S

HANDBOOK

ARMY STRONG

DEPARTMENT OF THE ARMY

29 MAY 2007

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TABLE OF CONTENTS OTSG / MEDCOM Warrior In Transition – RC Soldier’s Handbook ................................... 1

CHAPTER 1: INTRODUCTION.................................................................................. 5 1-1. PURPOSE............................................................................................................ 5 1-2. APPLICABILITY ............................................................................................... 5 1-3. GENERAL........................................................................................................... 5 1-4. .............................................................................................................................. 5 1-5. EXPLANATION OF ABBREVIATIONS & TERMS ....................................... 5 1-7. .............................................................................................................................. 5

CHAPTER 2: COMMAND & CONTROL (C2) .......................................................... 6 2-1. COMMAND & CONTROL (C2): ...................................................................... 6 2-2. COMMANDER’S OPEN DOOR POLICY........................................................ 7 2-3. FORMATIONS & SOLDIER ACCOUNTABILITY......................................... 7 2-4. TRAINING & EDUCATION ............................................................................. 7 2-5. PHYSICAL TRAINING ..................................................................................... 8 2-6. WEIGHT CONTROL PROGRAM..................................................................... 8 2-7. JOB ASSIGNMENTS ......................................................................................... 8 2-8. TRANSPORTATION ......................................................................................... 9 2-9. PRIVATELY OWNED VEHICLES (POV): ...................................................... 9 2-10. BILLETING & UNIT BARRACKS ............................................................... 10 2-11. UNIFORM POLICY ....................................................................................... 12 2-12. GRATUITOUS ISSUE OF CLOTHING FOR OIF/OEF HOSPITALIZED SOLDIERS ............................................................................................................... 12 2-13. PROMOTIONS ............................................................................................... 13 2-14. PERFORMANCE EVALUATIONS .............................................................. 13 2-15. LEAVES & PASSES....................................................................................... 13 2-16. MEDICAL CARE WHILE ON LEAVE OR PASS ....................................... 15 2-17. CONDUCT...................................................................................................... 15 2-18. MILITARY COURTESY................................................................................ 15 2-19. INDEBTEDNESS & DISHONORED CHECKS............................................ 16 2-20. SEXUAL HARASSMENT ............................................................................. 16 2-21. EQUAL OPPORTUNITY (EO)...................................................................... 16 2-22. FRATERNIZATION....................................................................................... 17 2-23. USE OF ALCOHOL & DRUGS..................................................................... 17 2-24. GAMBLING.................................................................................................... 18

CHAPTER 3: ADMINISTRATION & SUPPORT...................................................... 19 3-1. FINANCE.......................................................................................................... 19 3-2. PAY INQUIRIES .............................................................................................. 20 3-3. INCAPACITATION (INCAP) PAY................................................................. 21 SECTION II: INSTALLATION SUPPORT SERVICES ........................................ 21 3-4. EMERGENCIES (911): . .................................................................................. 21 3-5. MEDICAL SICK CALL ................................................................................... 21 3-6. DENTAL SICK CALL...................................................................................... 22 3-7. CHAPLAIN SERVICES ................................................................................... 22

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3-8. DINING FACILITIES (DFAC) ........................................................................ 22 3-9. LEGAL ASSISTANCE..................................................................................... 22 3-10. MWR (MORALE, WELFARE & RECREATION) & BOSS (BETTER OPPORTUNITIES FOR SINGLE SOLDIERS): ..................................................... 23 3-11. VOTING ASSISTANCE................................................................................. 23

CHAPTER 4: MEDICAL CARE ................................................................................ 24 4-1. MEDICAL CARE ............................................................................................. 24 4-2. CASE MANAGERS.......................................................................................... 24 4-3. PRIMARY CARE MANAGER (PCM)............................................................ 26 4-4. MEDICAL TREATMENT EXPECTATIONS................................................. 26 4-5. PATIENT RIGHTS ........................................................................................... 28 4-6. PATIENT RESPONSIBILITIES ...................................................................... 29 4-7. MAINTENANCE OF MEDICAL RECORDS ................................................ 30 4-8. MEDICAL NON-COMPLIANCE.................................................................... 30 4-9. HEALTH INSURANCE PORTABILITY & ACCOUNTABILITY ACT (HIPAA):................................................................................................................... 31

CHAPTER 5: MEDICAL HOLDOVER (MHO) OPERATIONS .............................. 33 5-1. MEDICAL HOLDOVER (MHO) OPERATIONS ........................................... 33 5-2. ENTRY INTO WTU & MRP STATUS ........................................................... 33 5-3. MEDICAL RETENTION PROCESSING (MRP ............................................. 36 5-4. MEDICAL RETENTION PROCESSING 2 (MRP2) ....................................... 37 5.5. COMMUNITY-BASED HEALTH CARE ORGANIZATION (CBHCO) ...... 38

CHAPTER 6: PHYSICAL DISABILITY PROCESSING.......................................... 41 6-1. PERMANENT PROFILES ............................................................................... 41 6-2. LINE OF DUTY (LOD):................................................................................... 41 6-3. PHYSICAL PERFORMANCE EVALUATION SYSTEM (PPES)................. 42 6-4. MEDICAL/MOS RETENTION BOARD (MMRB)......................................... 43 6-5. PHYSICAL DISABILITY EVALUATION SYSTEM (PDES) ....................... 43

CHAPTER 7: TRANSITION ...................................................................................... 45 7-1. TRAUMATIC-RELATED STRESS................................................................. 45 7-2. DEPARTMENT OF VETERANS AFFAIRS (DVA or VA) ........................... 47 7-3. ARMY CAREER & ALUMNI PROGRAM (ACAP) ...................................... 48 7-4. RECOVERY EMPLOYMENT ASSISTANCE LIFELINE (REALifeline)..... 49 ARMY VALUES...................................................................................................... 51 OFFICER'S CREED................................................................................................. 53 APPENDIX A: REQUIRED & RELATED PUBLICATIONS .............................. 54 APPENDIX B: REQUIRED & RELATED FORMS.............................................. 56 APPENDIX C: SAMPLE WELCOME LETTER ................................................... 57 APPENDIX D: SAMPLE INDIVIDUAL REFERENCE SHEET.......................... 58 APPENDIX G: SAMPLE SOLDIER’S APPOINTMENT SCHEDULE ............... 62 APPENDIX H: GLOSSARY................................................................................... 63

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DISCLAIMER: THE CONTENT IN THIS HANDBOOK PROVIDES GENERAL INFORMATION TO A BROAD AUDIENCE, AND IS NOT INTENDED TO PROVIDE SPECIFIC INDIVIDUALIZED INFORMATION THAT IS COVERED IN DETAIL IN THE REFERENCED DEPARTMENT OF DEFENSE AND ARMY PUBLICATIONS. IN SOME CASES, INDIVIDUAL CIRCUMSTANCES WILL RESULT IN ACTIONS AND PROCEEDINGS THAT ARE DIFFERENT FROM THOSE DESCRIBED IN THIS HANDBOOK.

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CHAPTER 1: INTRODUCTION 1-1. PURPOSE: The purpose of this handbook is to provide Medical Holdover

(MHO)/Warrior in Transition (WT) Soldiers with information on MHO Warrior Transition operations, medical treatment and disability processing, as well as guidance on standards of conduct and key policies. See applicable local Warrior Transition Unit (WTU) company policy memoranda and standing operating procedures (SOP) for specific directives.

1-2. APPLICABILITY: This Warrior in Transition Program MHO Soldier Handbook

applies to all Soldiers on MRP orders assigned or attached to a Warrior Transition Unit (WTU), including Medical Retention Processing Units and Community Based Health Care Organization (CBHCO). All WT Soldiers are required to read and familiarize themselves with this handbook. Soldiers will follow the provisions in this handbook while in a MHO Warrior Transition status.

1-3. GENERAL: Medical Holdover operations include comprehensive Command and

Control (C2), administrative and logistical support, medical evaluation, treatment, disability processing (when indicated), and transition support for mobilized Reserve Component (RC) Soldiers with sustained or aggravated injuries or illness while on active duty. The Surgeon General and US Army Medical Command (MEDCOM) have the responsibility for executing MHO operations for the Army. The US Army Installation Management Command (IMCOM), the US. Army Human Resources Command (HRC), the US Army Finance Command (FINCOM), the Army G-1, and other Department of The Army (DA) staff elements and agencies are supporting Commands.

1-4. REFERENCES: Required and related publications and prescribed and

referenced forms are listed in Appendices A and B. 1-5. EXPLANATION OF ABBREVIATIONS & TERMS: Abbreviations and

special terms used in this handbook are defined in the Glossary. 1-6. WOUNDED SOLDIER AND FAMILY HOTLINE: The Acting Secretary of

the Army and the Army Chief of Staff have established a Wounded Soldier and Family Hotline. This hotline is committed to: 1) offer injured Soldiers and Family members an avenue to seek solutions to medically related issues, and 2) provide the senior Army leadership an insight on Soldier medical issues so that appropriate action can be taken to improve the Army’s medical services. The hotline can be reached on its toll free number 1-800-984-8523, its overseas DSN 312-328-0002, its stateside DSN 328-0002 or via its email address wsfsupport@conus.army.mil.

1-7. FOLLOW-UP RESPONSIBILITY: The MHO Program under the Office of

the Surgeon General (OTSG) of the Army is responsible for the content of this Handbook. It will be revised periodically as program or policy changes occur.

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CHAPTER 2: COMMAND & CONTROL (C2)

SECTION I: POLICIES AND ACCOUNTABILITY 2-1. COMMAND & CONTROL (C2): The Army has established dedicated

Command and control (C2) units for Warriors in Transition (WT). These Warrior Transition Units (WTU) units include Medical Hold Units, Medical Retention Processing Units (MRPU) and Community Based Health Care Organizations (CBHCO). CBHCOs are off-installation company-level Commands under MEDCOM. In addition to the usual C2 responsibilities, WTU Commanders ensure that Soldiers are compliant with their medical treatment plans, provide billeting that supports their functional limitations, resolve administrative issues, assign meaningful Title 10 work and assist Soldiers assigned or attached to the WTU in their transition from active duty. The Command and control team consists of:

a. Commander. The Commander coordinates with the MHO team daily,

including health care professionals, administrative and logistical support staff, and their own Command and control staff. Commanders are responsible for providing reports and other support to MEDCOM. MHO Commanders are mature leaders and decision-makers who can balance requirements with good judgment.

b. Executive Officer. Executive Officers (XO) stand in for Commanders in

their absence, assist Commanders in fulfilling their responsibilities, and oversee the staff administrative functions.

c. First Sergeant. First Sergeants (1SG) serve as the senior enlisted advisor

to the Commander. Positioned between the Platoon Sergeants (PSG) and the Commander in the “chain-of-Command”, they provide direct supervision of Platoon Sergeants.

d. Platoon Sergeants and Squad Leaders. All WTU Soldiers are assigned a

Platoon Sergeant and Squad Leader. In addition to the usual responsibilities, the platoon sergeant with the squad leader will:

(1) Communicate daily with all assigned WTU Soldiers. (2) Maintain a communication log for each WTU Soldier. (3) Establish a familiarity with each Soldier in order to be the primary

contact when the Soldier experiences problems (i.e. pay issues, Family problems, stress reactions, etc).

(4) Coordinate closely with nurse case managers and other members of

the care team.

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(5) Ensure Soldiers keep their scheduled medical appointments, and other in- and out-processing requirements.

(6) Make recommendations for referring eligible Soldiers to CBHCOs.

2-2. COMMANDER’S OPEN DOOR POLICY: In accordance with Army

Regulation 600-20, Army Command Policy, “Commanders will establish an open door policy within their Commands. Soldiers are responsible to ensure that the Commander is aware of problems that affect discipline, morale, and mission effectiveness; and an open door policy allows members of the Command to present facts, concerns, problems of a personal and professional nature, or other issues which the Soldier has been unable to resolve.” The Commander’s open door policy does not supersede the use of the chain-of-Command. The chain-of-Command resolves problems/issues and suggests improvements.

2-3. FORMATIONS & SOLDIER ACCOUNTABILITY: Commanders are

responsible for the full accountability of their Soldiers, regardless of rank or component. For the purposes of accountability and information sharing, all Soldiers in duty status shall be at formation. Platoon Sergeants may excuse Soldiers with medical appointments or other scheduled appointments. Soldiers are responsible for keeping Platoon Sergeants informed of events that take them away from their regularly scheduled activities. Formation times and location are listed on the unit’s training schedule unless otherwise directed by the Commander/1SG.

2-4. TRAINING & EDUCATION: All Soldiers are required to attend scheduled

training. Since more than 80% of all Soldiers on MRP orders return to duty, Soldiers shall maintain their military skills. In addition, there will be special focused training for the WTU Soldier to assist in the transition back to civilian life. Training includes briefings on Department of Veteran Affairs (DVA or VA) benefits, ACAP, the Physical Disability Evaluation Process (PDES), and transition processing.

a. Training schedules are posted on platoon bulletin boards and announced at

formation. The PSG will also have copies of training schedules and will be available to answer any questions.

b. Soldiers are required to attend all scheduled training unless they have an

appointment specific to their medical treatment plan or are excused by their PSG. Soldiers should notify their PSG if any training violates their Physical Profile (DA Form 3349) or interferes with their medical treatment and healing. Except as noted above, WTU Soldiers shall participate in training and education events in anticipation of their return to full duty.

c. Military Education: WTU Soldiers are eligible to attend military courses

under the following conditions:

(1) Course work will not delay or interfere with the Soldier’s medical treatment or disposition plan

(2) Course work does not violate any limitations found in the Soldier’s

Physical Profile (DA Form 3349)

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(3) Soldier has received permission from their chain-of-Command, nurse

case manager and duty assignment supervisor.

d. Civilian Education: , WTU Soldiers on MRP orders are eligible to attend civilian higher education courses at any of the local colleges or universities under the following conditions:

(1) School hours do not interfere with the Soldier’s medical treatment or

disposition plan (2) School hours do not interfere with the Soldier’s duty assignment

(3) Soldiers have received permission from their chain-of-Command,

nurse case manager and duty assignment supervisor. 2-5. PHYSICAL TRAINING: Physical training (PT) time and location is annotated

on the training schedule unless otherwise directed by the Commander/1SG. Commanders/1SGs shall modify their PT programs as appropriate to complement WTU Soldiers’ treatment plans and to facilitate WTU Soldiers’ return to duty. Personnel may be required to attend PT formations and perform PT within the confines of their Physical Profile (DA Form 3349). WTU Soldiers are encouraged to coordinate with the Physical Therapy Service at the local medical treatment facility (MTF) to develop an individual PT program based on their current physical condition. Soldiers will keep their chain-of-Command informed of any changes in their physical profile recommendations and will carry their profile DA Form 3349 with them at all times.

2-6. WEIGHT CONTROL PROGRAM: Although physical restrictions from illness

or injury can be challenging, Soldiers are accountable for and shall adhere to weight standards IAW AR 600-9. All WTU Soldiers will be weighed (and taped, if indicated) within 30 days of their arrival. Soldiers who are overweight or have excessive levels of body fat will be counseled and placed on a modified Army Weight Control program. Through the assistance of medical personnel and nutrition-based dieting, WTU Soldiers should be successful in maintaining Army weight standards.

2-7. JOB ASSIGNMENTS: All WTU Soldiers are considered for job assignments.

The Soldier’s first priority is to receive medical care, arrive at appointments promptly, and optimize their medical status. Job assignments, within the limits of the Soldiers’ physical profile, enable Soldiers to enhance their overall well-being through mental and physical exercise, demonstrate retention and promotion potential, and, in some cases, serve as a trial of duty IAW AR 40-501.

a. Soldiers are normally assigned Title 10 duties while on MRP orders. Duties

will be assigned within the limits of the Soldiers’ physical profile limitations and appropriate to their rank. The temporary nature of MRP status is considered when determining appropriate job assignments, as well as previous skills and training. If asked to perform duty that violates Soldier’s

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physical profile, the Soldier should immediately notify his/her job supervisor and/or platoon sergeant.

b. Rules of engagement include:

(1) Approved and signed Memorandum of Agreement (MOA)

between the WTU Command and the duty assignment Command. The MOA will address responsibility for daily supervision and accountability at assigned place of duty. Although accountability is ultimately the WTU Commander’s responsibility, the onsite work supervisors will assist the Commander.

(2) Soldiers shall report for duty on time and perform duties for a

normal duty day, unless properly excused (including approved profiles that limit the workday). The Command shall approve all absences (i.e. medical appointments). In addition, all Soldiers shall keep their work place supervisor informed of any functional limitations and projected absences.

(3) Soldiers will maintain proper military bearing and conduct at all

times, and comply with the established policies and procedures of their assigned place of duty. The WTU Commander and workplace supervisor will negotiate any discrepancies.

(4) Soldiers will not terminate job assignment without Command

approval. (5) Failure to comply may result in UCMJ action.

2-8. TRANSPORTATION:

a. Transportation is available for official purposes for WTU Soldiers residing in unit barracks (i.e. medical appointments, hospital/health clinic). Installation transportation systems may be available to provide transportation to assigned duty locations. Some installations also provide shuttle buses or vans to common areas on-installation (i.e. PX, Commissary, fitness centers, etc). Under the provisions of the JTR, the Army does not transport Soldiers to or from their place of residence.

b. As a condition of eligibility for the CBHCO, Soldiers assigned or attached to

a CBHCO are responsible for providing their own transportation to duty location and medical appointments. .

2-9. PRIVATELY OWNED VEHICLES (POV):

a. Soldiers on mobilization and MRP orders are not authorized privately owned vehicles (POV) and thus are unable to request reimbursement for

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mileage or extra travel days. Commanders may authorize leave or pass for Soldiers to go home and retrieve their POV at their own expense.

b. Soldiers shall register their POV at the appropriate Vehicle Registration

Center. c. Failure to follow posted speed limits or drive a vehicle under the influence

of alcohol/drugs may result in forfeiture of post driving privileges and/or punitive action under the UCMJ.

d. All personnel will park in approved parking areas. Failure to comply may

result in suspension of driving privileges. e. It is illegal to carry a firearm in a POV.

2-10. BILLETING & UNIT BARRACKS:

a. Billeting is comparable to permanent party billeting on-installation. Since permanent party billeting varies among and within installations, WTU billeting may also vary. It is IMCOM policy that billeting be provided to accommodate the functional limitations of WTU Soldiers. WTU Soldiers will comply with installation policies and requirements.

b. Commanders ensure that their Soldiers are appropriately billeted. They

also coordinate, develop and enforce local policies while recognizing the unique requirements of WTU Soldiers. At a minimum, local policies shall address:

(1) Room assignments.

(2) Security and safety in the barracks.

(3) Prohibited items (such as illegal contraband and drug

paraphernalia)

(4) Alcohol

(5) Firearms

(6) Prescription medications

(7) Tobacco products

(8) Visitors

(9) Sexual activity

(10) Health and welfare inspections

(11) Misconduct and unprofessional conduct

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(12) Noise restriction hours

(13) Privately owned vehicles (POV),

(14) Accessibility for Soldiers with functional limitations

(15) General good order and discipline in the barracks.

c. Quiet hours are posted and observed at all times. d. Visiting hours will be published and followed on weekdays and on

weekends. e. Smoking is permitted only in designated smoking areas. f. Alcohol is not permitted outside the occupant’s room. Soldiers shall be 21

years of age to purchase, possess or consume alcohol. Refer to installation policy.

g. Contraband (e.g., explosives, firearms, weapons, BB/pellet guns, paint ball

guns, illegal drugs, drug paraphernalia) will not be stored, used, or sold in the billeting area.

h. Safety is the responsibility of every Soldier. Report hazards to the chain-of-

command immediately. i. Report all Billet deficiencies to the floor NCO and forward it to the company

HQ immediately. j. Movement of furniture is prohibited without prior approval from the

Commander/1SG k. Heat-producing personal appliances are only permitted in designated areas

(i.e. hot pots, hot plate, toaster, microwave, etc.). The Fire Marshall shall inspect heat-producing appliances prior to use in designated areas.

l. Shorts, T-shirts and underwear are the minimum clothing to be worn when

entering or leaving the latrine/shower, unless otherwise prescribed. m. All doors will be marked with occupant’s name, rank and 1SG’s name. n. No major vehicular repairs or maintenance in the parking area. Most

installations have self-service automotive centers available for such purposes.

o. Unit leadership will conduct billets inspections and safety checks to protect

the health and welfare of the Soldiers.

p. IAW AR 600-20, Army Command Policy, Commanders are responsible for taking appropriate action in any case where a Soldier’s conduct violates good order and discipline or the UCMJ. Commanders are also responsible

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for taking appropriate action to ensure Soldiers’ safety and security in the barracks. Commanders shall coordinate closely with medical authorities when medical and Command issues overlap.

2-11. UNIFORM POLICY:

a. WTU Soldiers will comply with AR 670-1, Wear and Appearance of Army Uniforms and Insignia, as well as local uniform policies that prescribe when uniforms are to be worn, specifically utility and combat uniforms.

b. Utility uniforms (ACU, BDU, DCU, etc.) may or may not be worn off-

installation during duty hours. Commanding Generals set the policy for their installations.

c. Soldiers in uniform may not consume alcohol nor enter establishments

where the consumption of alcohol is the primary business. . d. A medical condition that requires the modification of the Army uniforms is

annotated on the approved Physical Profile (DA Form 3349). e. Many installations have established procedures for the gratuitous issue of

uniform to Soldiers who have lost or damaged their uniforms in combat or an evacuation from the theater of operations (See paragraph 2-12 below).

f. No mixing of military uniforms and civilian clothing, except for the Gore-Tex

jacket, field jacket, black windbreaker, or overcoat without patches or insignia.

g. Installations have established policies for the wear of the Improved Physical

Fitness Uniform (IPFU) beyond the provisions of AR 670-1. Local policy might include the following provisions:

(1) The IPFU will be worn for PT during normal PT hours. (2) The IPFU may not be worn in the PX, commissary or other public

buildings. (3) The IPFU may be worn for medical appointments such as physical

exams, physical therapy, etc.]

h. IAW current Army policy, Soldiers may wear combat uniforms (ACU, BDU, DCU) when in travel status. Soldiers may not travel in commercial vehicles in the IPFU.

2-12. GRATUITOUS ISSUE OF CLOTHING FOR OIF/OEF

HOSPITALIZED SOLDIERS:

a. WTU Soldiers who are medically evacuated from the CENTCOM AOR, primarily Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF), to CONUS medical treatment facilities (MTF) without their military

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uniforms or other personal clothing effects may receive a gratuitous issue of military uniforms and civilian clothing.

b. MHO Commanders will coordinate with the local MTF Patient

Administration Division (PAD) to validate and verify individual Soldier’s need and eligibility for gratuitous issue of civilian clothing (up to $250.00). PAD will initiate the one-time authorization voucher for civilian clothing, which is only valid at the installation AAFES stores.

c. Soldiers are encouraged to compile a complete list of necessary clothing

items prior to going shopping as any unused balance immediately expires and cannot be used later.

d. Clothing articles that are procured under this program will be separated

from other personal purchases at the cash register. Since no funds are exchanged, the Soldier will verify the receipt of clothing on the original authorization voucher. Soldiers may keep gratuitous issue of civilian clothing items; they are not hand receipted items and are not turned in upon REFRAD or separation.

e. Medical evacuees requiring military clothing items are authorized a

gratuitous partial issue through the Military Clothing Sales Store (MCSS). See your unit supply personnel for additional information.

f. Personnel who normally reside in the local area of the MTF will not be

authorized gratuitous clothing issue. Soldiers who are required to travel back to their home station or who are authorized to travel on convalescent leave from the MTF and return or go to another MTF IAW U7210 of the JFTR might be eligible for this entitlement.

2-13. PROMOTIONS: Refer to AR 600-8-19 or AR 135-155 and the PPG for current

guidance for Soldiers in WT status. 2-14. PERFORMANCE EVALUATIONS: In accordance with AR 623-3, time

spent in MRP status is considered unrated time. Therefore, Noncommissioned Officer Evaluation Reports (NCOER) and Officer Evaluation Reports (OER) are not authorized. Soldiers who distinguish themselves may receive positive counseling, memorandums of commendation, and military performance or service awards.

2-15. LEAVES & PASSES:

a. WTU Soldiers are eligible for normal leaves and passes IAW AR 600-8-10. In addition to the AR and local policy, refer to G-1 PPG and Consolidated Guidance for current requirements.

(1) Leave and pass status will not delay nor interfere with medical

evaluation and treatment, or disposition activities. WTU Soldiers are encouraged to take leave between medical appointments. Soldiers shall coordinate their leave requests with their case

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managers to ensure no missed appointments and no delays in medical board processing.

(2) It is imperative that the Command coordinates with the medical

personnel re: leave and passes. Commanders and medical authorities are encouraged to support WTU Soldiers’ use of earned leave time and passes to assist them in reuniting with their families and communities.

(3) Soldiers may not be authorized ordinary leave or pass in

conjunction with travel from an installation to a CBHCO. Soldiers may travel via POV rather than government air to CBHCO. Reimbursement of travel expenses and time will not exceed the limits of the constructive airline ticket IAW the JFTR.

b. IAW AR 600-8-10, the following regulatory provisions are noted:

(1) Leaves and special passes are approved via a DA Form 31,

Request and Authority for Leave. Soldier shall provide a non-military address, phone number and advise the Command of any changes.

(2) Special passes are limited to 96 hours, and shall include at least 2

consecutive non-duty days (i.e. weekend). (3) Leave will not be granted in conjunction with a pass, including

convalescent leave (CONLV). A minimum of one duty day shall be scheduled between a leave and a special pass.

(4) Soldiers shall be at their residence or place of duty when the leave

or pass begins and ends. Failure to comply with this requirement is a violation of the UCMJ and puts the Soldier at risk of “line of duty – no” determinations in the event of a motor vehicle accident, etc.

(5) Most installations require a safety assessment and/or briefing

when traveling longer distances. Refer to your local policy. (6) Commanders are responsible for establishing equitable leave and

pass policies. Passes are not intended to preserve leave time for “selling back” at REFRAD or separation. Many installations have policies that limit the number of special passes (especially 4-day passes) per Soldier.

(7) Commanders retain approval and recall authority for all passes

and leaves. (8) Convalescent leave is a non-chargeable absence from duty

granted to expedite a Soldier’s return to full duty after illness, injury, or childbirth. The unit Commander is the approval authority for up to 30 days convalescent leave (42 days after normal

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pregnancy and childbirth) for a Soldier returning to duty after illness or injury. Hospital Commanders are the only approval authority for requests in excess of 30 days (or in excess of 42 days of childbirth).

(9) Soldiers granted convalescent leave for illness or injury incurred in

the line of duty while eligible for receipt of hostile fire and imminent danger pay under Section 310, Title 37, United States Code (37 USC 310) are entitled to funded travel and transportation per JFTR, paragraph U7210.

2-16. MEDICAL CARE WHILE ON LEAVE OR PASS: WTU Soldiers shall be

briefed on procedures for obtaining medical care prior to taking leave or pass. Whenever possible, Soldiers who require medical care should go to the nearest military MTF (Army, Navy or Air Force). Please contact your nurse case manager immediately. If there is not a military MTF in the area, Soldiers may go to an appropriate civilian hospital as follows:

a. For Emergency Care: Go to the nearest Emergency Room or call 911.

TRICARE pre-authorization is not necessary for an emergency. b. For Urgent Care: Call the nearest Emergency Room or TRICARE help line

to determine if this is an emergency. c. For non-emergent/non-urgent care, TRICARE pre-authorization is required.

Contact your case manager or call TRICARE toll-free number for assistance.

SECTION II: MILITARY CONDUCT 2-17. CONDUCT: Military personnel will conduct themselves in a professional

manner to avoid bringing discredit upon themselves, the unit, or the Army. Undesirable conduct includes, but is not limited to, lying or falsifying information (including medical condition or status), drunk/reckless driving, drunk/disorderly conduct, and offensive language and gestures, fraud, as well as failure to satisfy financial obligations.

2-18. MILITARY COURTESY:

a. Courtesy is respect for and consideration of others. b. The salute is a sign of mutual respect, unit pride, and esprit de corps.

Salutes are rendered by enlisted members to commissioned officers and warrant officers and by junior officers to senior officers, except when in an area designated “NO HAT, NO SALUTE”. Salute distance is “recognition” distance. The salute should be rendered when within six (6) paces. Saluting is not required while operating a motor vehicle. Soldiers will salute General Officer/Colonel Command vehicles identified by a plate depicting their rank or IAW local installation policy.

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c. The first Soldier to sight an officer who is higher in rank than the officers

present in a room will call “attention”. A similar courtesy of calling “at ease” is extended for SGMs.

d. When an officer enters a room, Soldiers who are working will come to the

position of attention (parade rest for CSM) when the officer/CSM addresses them.

e. During conversations, all military personnel will come to the position of

attention and face a senior officer (or parade rest for senior NCOs) when addressed.

f. When an officer approaches a formation or work detail, the Soldier in

charge calls “attention” and renders a salute for the entire group. g. When an officer approaches a group not in formation, the first person

sighting the officer calls “attention” and everyone in the group faces the officer and renders a salute.

h. Reveille and Retreat: When in uniform, upon hearing the music, assume

the position of attention. Render a salute upon playing “to the colors.” When in civilian attire, assume the position of attention and place your right hand over your heart. Personnel driving motor vehicles will pull over and stop. All occupants should exit the vehicle and comply with the established procedures listed above.

2-19. INDEBTEDNESS & DISHONORED CHECKS:

a. Soldiers will manage their personal affairs and pay debts promptly. Knowingly writing checks on an insufficiently funded account may result in punishment under UCMJ. Financial assistance is available at the Army Community Service (ACS):

b. Soldiers with dependents are required to pay court-ordered spousal / child

support. Non-compliance is punishable under UCMJ. 2-20. SEXUAL HARASSMENT: AR 600-20, Army Command Policy states, “The

policy of the Army is that sexual harassment is unacceptable conduct and will not be tolerated.” Anyone who uses or condones implicit or explicit sexual behaviors to control, influence, or affect the career or pay of another is engaging in sexual harassment. Unwelcome verbal comments, gestures, or physical contact of a sexual nature is also sexual harassment. Report violations through your chain-of-Command to the unit Commander or equal opportunity (EO) representative.

2-21. EQUAL OPPORTUNITY (EO): The Army will provide equal opportunity and

fair treatment for military personnel, Family members and DA civilians without regard to race, color, gender, religion, or national origin, and provide an environment free of unlawful discrimination and offensive behavior. Report EO

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violations through your chain-of-Command to the unit Commander or EO representative.

2-22. FRATERNIZATION: AR 600-20 defines fraternization as inappropriate or

unprofessional relationships between military personnel.

a. Relationships between Soldiers of different ranks are prohibited and punishable under UCMJ if they:

(1) Compromise or appear to compromise the integrity of supervisors or

the chain-of-Command. (2) Cause actual or perceived partiality or unfairness. (3) Involve or appears to involve improper use of rank or position for

personal gain. (4) Are perceived to be exploitative or coercive in nature. (5) Create an actual or perceived adverse impact on discipline,

authority, morale, or the ability of Command to accomplish the mission.

b. Prohibited acts include, but are not limited to:

(1) Engaging in sexual harassment, fraternization, or unprofessional

associations. (2) Engaging or attempting to engage in a financial or business

dealings with another Soldier. (3) Borrowing from or lending money to another Soldier or civilian

employee.

2-23. USE OF ALCOHOL & DRUGS:

a. The consumption (including “being under the influence”) of alcohol during duty hours or while in uniform is prohibited.

b. Soldiers shall be at least 21 years of age to possess or consume alcohol. See local installation policy for more information.

c. The use of illegal drugs is a serious offense. Random drug screening will

be conducted IAW Army and installation policy. d. Soldiers who are in possession, found selling or test positive of illegal drugs

are subject to punishment under the UCMJ.

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e. Soldiers receiving adverse administrative action or UCMJ punishment for alcohol or drug related offenses would be released from the MRP program at the Commander’s discretion.

f. The Army Substance Abuse Program (ASAP) is available to assist Soldiers

who recognize that they have a drug or alcohol problem. Soldiers needing assistance may contact ASAP without retribution IAW Army policy.

2-24. GAMBLING: Gambling is prohibited on all Army (or other Federal) installations

in CONUS.

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CHAPTER 3: ADMINISTRATION & SUPPORT SECTION I: FINANCE 3-1. FINANCE: Soldiers returning from the theater of operations by either MEDEVAC

or normal redeployment shall process through the finance station at the Soldier readiness processing (SRP) site or designated installation finance office.

a. Soldiers on MRP orders might be entitled to the following special pays:

(1) Family Separation Allowance (FSA) IAW DoD Financial Management Regulation (DoDFMR) 7000.14-R, Volume 7A, Chapter 27, for Soldiers whose dependents (including dependents receiving child support) do not reside within a reasonable commuting distance (refer to local commuting policy, but generally 50 miles one way or 1.5 hours of driving time) of their assigned duty station. Soldiers who commute daily are not entitled to FSA regardless of the distance or driving time. The FSA rate is $250 per month. At any time, if a Soldier resides with his/her dependents for a period exceeding 30 consecutive days, the Soldier is no longer entitled to FSA. Soldiers on convalescent leave at home for greater than 30 days will stop receiving FSA pay beginning the 31st day. Address your individual questions about FSA with the local finance office.

(2) Basic Allowance for Housing (BAH) IAW DoDFMR Volume 7A,

Chapter 26. When applicable, BAH is based upon recorded home of record at the time of mobilization. Soldiers may not change their home of record during mobilization except when approved by the Department (for example, Soldiers whose homes were destroyed during Hurricane Katrina).

(3) Basic Allowance for Subsistence (BAS) IAW DoDFMR Volume

7A, Chapter 25. (4) Clothing Allowance IAW DoDFMR Volume 7A, Chapters 29 and

30. Enlisted clothing allowance at the one-year mark or earned prorated periods. Officers may receive an additional uniform allowance, if applicable.

(5) Per-diem (for incidentals) rate of $3 per day for temporary change

of station (TCS) orders in CONUS. If a Soldier resides within local commuting distance (refer to local commuting policy), they are not entitled to per diem.

(6) Laundry expenses may be claimed up to maximum

reimbursement of $2.00 per day when the Soldier is stationed in

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CONUS and resides away from home (refer to local commuting policy) for seven (7) or more consecutive nights.

b. Upon redeployment from combat theater, the following entitlements will stop:

(1) Hostile Fire Pay / Imminent Danger Pay (2) Hazardous Duty Pay (3) Hardship Duty Pay

(4) Tax-Exempt Status

NOTE: Contact your local servicing finance office for clarification and eligibility requirements if your injury or illness was sustained during theater of combat operations or in a designated combat zone

c. Other Special Pays: Soldiers might be eligible for other special pays such as

Combat Related Injury Rehabilitation Pay (CIP) and Traumatic Injury Protection rider under the Traumatic-SGLI (TSGLI). These pays were included in the FY 06 National Defense Authorization Act (NDAA), however, these pays are not automatic; the WT Soldier must apply for the benefit. Soldiers should consult their personnel and finance specialists for details.

d. myPay Account: Soldiers should sign up for MyPay, if not already in

possession of a myPay PIN. Soldiers may designate a primary Family member for “view / print” only access to myPay.

3-2. PAY INQUIRIES: Soldiers experiencing issues or problems with their pay

should seek assistance from their chain-of-Command first. This is an effective procedure because it affords unit leaders the opportunity to resolve pay concerns on behalf of their Soldiers in an expeditious manner.

a. Army National Guard (ARNG) Soldiers who encounter unresolved pay issues

may call the ARNG Financial Services at 1-877-ARNGPAY, (317) 510-3243 or DSN 699-3243 or via FAX at (317) 510-7017 or send email message to arng-milpay@arng-fsc.ngb.army.mil.

b. Army Reserve (USAR) Soldiers who encounter unresolved pay issues may

call the Ft. McCoy Reserve Pay Customer Service at 1-877-462-7782 or via FAX at (608) 388-7436 or send email message to usarcpayinquiry@emh2.mccoy.army.mil.

c. Useful websites:

(1) AKO (go to Self-Service, My Finance) at http://www.us.army.mil

(2) DoD Per Diem, Travel and Transportation Committee at https://secureapp2.hqda.pentagon.mil/perdiem/

(3) Deputy Chief of Staff, Army G-1 at http://www.armyg1.army.mil/

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3-3. INCAPACITATION (INCAP) PAY a. After release from active duty (e.g.: REFRAD) Reserve Component (RC)

Soldiers might be eligible for incapacitation (INCAP) pay if physically disabled as a result of an injury, illness or disease incurred in the line of duty that prevents the Soldier from performing his or her military or civilian job. Eligible Soldiers will receive his or her demonstrated loss of income up to the equivalent rate of full pay and allowanced for his or her rank and length of service. NOTE: INCAP pay generally only compensates Soldiers who have been found to meet Army retention standards, but are unable to perform their civilian job. (See DoDD 1241.1, Reserve Component Medical Care and Incapacitation Pay for Line of Duty Conditions and AR 135-381, Incapacitation of Reserve Component Soldiers.)

b. The INCAP pay program is administered by the Reserve Components.

Soldiers are not automatically entitled to INCAP pay. Eligibility for benefits is determined on a case-by-case basis with a maximum benefit of six (6) months. Soldiers are not eligible for benefits while on active duty.

c. INCAP pay may not be paid until a final line of duty (LOD) determination has

been made. If it is determined that a Soldier’s injury, illness or disease was incurred or aggravated in the line of duty (LOD – yes), then he or she might be eligible for INCAP pay upon release from active duty (REFRAD). If the Army determines the injury, illness or disease was not incurred or aggravated in the line of duty (LOD – no), the Soldier is not eligible for this benefit.

d. Eligibility begins after the last day of active duty, but it can take months to get

approved for INCAP pay. It is the Soldier’s responsibility to apply for INCAP pay after REFRAD. Soldiers apply for this benefit at their home station through his or her chain-of-Command. If you have questions about INCAP Pay, talk to your home RC unit administrator who can direct you to the individual who handles INCAP pay for your RC unit.

SECTION II: INSTALLATION SUPPORT SERVICES 3-4. EMERGENCIES (911): For medical emergencies (chest pain, difficulty breathing, profuse bleeding, loss of consciousness, etc) 911 or report to the nearest emergency room. DO NOT DRIVE YOURSELF TO THE EMERGENCY ROOM (ER) IF YOU ARE EXPERIENCING A TRUE EMERGENCY. If in doubt, call 911 or the ER for further instructions. Pre-authorization for treatment in a civilian hospital is not needed for medical emergencies, but you shall notify your case manager at the earliest opportunity. 3-5. MEDICAL SICK CALL: Sick call is for sudden acute illness or minor injuries

(colds, sprains, etc). Your case manager is your sick call resource during normal

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duty hours, and they will coordinate an appointment, as required. After hours and on weekends, go to the Acute Care Clinic in or near the Emergency Room (ER). NOTE: Soldiers should go to the ER only for an emergency or urgent medical problem and not because they missed sick call. If you have an acute or routine medical problem outside of sick call hours, contact your case manager. Soldiers will turn in their medical records, which are the property of the US Government, to their health record (HREC) custodian upon completion of their medical appointment.

3-6. DENTAL SICK CALL: All Soldiers are assigned to a primary dental clinic,

which establishes sick call hours or acute appointment schedules. Dental records, which are the property of the US Government, are maintained at this location. If you do not have a dental record at the time of an appointment, a record will be established for you. If a Soldier receives dental care while in Medical Holdover status, they are required to out process through the dental clinic in order to obtain their dental records.

3-7. CHAPLAIN SERVICES: The unit may have an assigned or designated

Chaplain. The Unit Ministry Team (UMT), consisting of the chaplain and chaplain assistant, exists to protect each Soldier’s First Amendment right to exercise their freedom of religion, as well as to provide confidential counseling. Individual appointments are available and can be scheduled by calling the Chaplain’s Office.

3-8. DINING FACILITIES (DFAC): Dining facilities (DFAC) are available for WTU

Soldiers residing in the barracks. If you are at a medical appointment at the installation MTF, and the MTF has a DFAC, you may request a pass to the MTF DFAC from the clinic or Information Desk.

3-9. LEGAL ASSISTANCE: The Legal Assistance Office of the Staff Judge

Advocate (SJA) is available to assist Soldiers with powers of attorney, wills, and other personal legal issues. They do not handle divorce, child custody or other Family law matters whose jurisdiction resides in the civil courts. They also do not handle criminal law matters.

a. Criminal law assistance is provided by the Trial Defense Office.

Commanders can coordinate appointments with an Army trial defense attorney, as appropriate.

b. Soldiers charged with an offense under the UCMJ or who are under

investigation for an offense chargeable under the UCMJ, which could result in dismissal or punitive discharge, are not eligible for disability processing, but will continue with their medical treatment plan unless the Soldier receives separation orders. The Soldier should receive medical treatment until the day the Soldier is separated from the Army. Escorts for Soldiers undergoing adverse actions might be required IAW local policy and Command judgment. This can include escorting Soldiers to health care and other personal appointments. Reasonable efforts will be made to provide patient privacy of protected health information (PHI) IAW statutory law and MTF policy.

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c. AWOL. Soldiers who are AWOL for more than 30 days will be dropped from the rolls (DRF) and all health care benefits will stop immediately.

3-10. MWR (MORALE, WELFARE & RECREATION) & BOSS (BETTER

OPPORTUNITIES FOR SINGLE SOLDIERS): Flyers with upcoming events and activities are posted in the platoon areas and at MWR facilities.

3-11. VOTING ASSISTANCE: The unit’s Voting Officer provides year round voting

information.

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CHAPTER 4: MEDICAL CARE 4-1. MEDICAL CARE: Every WTU Soldier is assigned a nurse case manager (CM)

and a primary care manager (PCM), which is a physician, nurse practitioner or physician’s assistant, to mange their medical care. Provider assignment may be based on medical diagnosis. All medical appointments are scheduled through your nurse case manager or assigned primary care manager IAW local policy. Do NOT call TRICARE to schedule medical appointments.

4-2. CASE MANAGERS: Every WTU Soldier is assigned a registered nurse case manager. The case manager is part of the TRIAD (case manager, physician, platoon sergeant) that will work with the Soldier throughout his stay in the WTU.

a. The nurse case manager works with each Soldier and their medical providers to:

(1) Facilitate and schedule all medical care and appointments. (2) Ensure that each Soldier receives appropriate evaluation and

treatment for all identified medical conditions.

(3) Establish open communications with each Soldier to identify other challenges they might be experiencing and act as a resource for the Soldier to access other medical systems such as the Veterans Health Administration (VHA or VA), Transition Assistance Management Program (TAMP), and the Medical Evaluation Board (MEB) of the Physical Disability Evaluation System (PDES).

b. Duties and responsibilities of nurse case managers:

(1) Use a Soldier-focused team approach based on communications,

collaboration, and coordination to meet the needs of Soldiers. The team typically includes the Soldier, case manager, providers (primary care providers and specialists), Physical Evaluation Board Liaison Officer (PEBLO), licensed clinical social worker care manager (SWCM), company Commander, first sergeant, and platoon sergeant.

(2) Document clinical history, which includes:

(a) Reviewing Physical Profiles (DA Form 3349), line of duty

(LOD) determinations (DA Form 2173, Statement of Medical Examination and Duty Status), and all available medical information

(b) Primary health concerns, for example, pain, medications,

physical functioning, mental status, and conditions treatment in theater

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(c) Any previous prognosis or plan for current condition (d) Determining each Soldier’s personal assessment of his

condition (e) Pertinent surgeries or treatments completed or pending (f) Physical systems assessment

(3) Document and coordinate the plan of care as developed by the

primary care manager (PCM) and other team members

(4) Coordinate appointments and consults with military medical treatment facilities and VA and TRICARE providers

(5) Communicate and coordinate with the Soldier’s chain-of-Command

and Soldier on a weekly basis; participate in weekly case review and team meetings

(6) Educate individual WTU Soldiers about their disease process, injury,

surgery, treatment, plan of care, physical disability processing, and other clinical concerns

(7) Manage the release of information IAW the Military Health System

(MHS) provisions of the Health Insurance Portability and Accountability Act (HIPAA). Educate Soldiers on requirements to sign release of information statements. Maintain patient confidentiality IAW MHS military exclusion provisions – share protected health information only with members of the Soldier’s care team and chain-of-Command.

(8) Work with the Soldier’s primary care manager (PCM) and specialty

care providers to coordinate parallel-treatment plans and disposition planning

(9) Assist the Soldier and PEBLO to track and expedite the PDES

process (10) Perform on-going activities:

(a) Contact Soldier after every medical appointment (except

physical/occupational therapy), surgical procedures, and during hospitalizations

(b) Document all contact and nursing assessments in the Soldier’s

medical record (c) Evaluate effectiveness of treatment and Soldier’s progression

toward optimizing recovery/wellness/quality of life (d) Report missed appointments to platoon sergeant

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(11) Conduct on-going assessment of a Soldier’s satisfaction with the WT

process. 4-3. PRIMARY CARE MANAGER (PCM): All Soldiers are assigned a primary

care manager (PCM), regardless of whether you receive care in the military direct health care system (MHS), the civilian TRICARE network, or the civilian purchased care system. Primary care managers are physicians, Family nurse practitioners, or physician assistants who manage your medical care, to include making referrals to medical specialists and sub-specialists. All appointments scheduled outside of the local Army MTF shall be approved by your PCM to ensure you do not incur personal liability for the cost of the medical care. Failure to obtain proper referral and authorization for medical care will result in a “point of service” charge, which is 50% of the billable cost of the medical care. Your PCM will complete a “medical problem list” that includes all of your medical conditions, both chronic and acute. Normally, you should first call your PCM (or clinic) if you have an acute medical condition and need a “sick call” appointment or any other routine appointment. Your PCM will also complete the medical portion of your line of duty (DA Form 2173, Statement of Medical Examination and Duty Status), temporary and permanent profile(s), and initiate a medical evaluation board, if required. If you have not been assigned a PCM or do not know who your PCM is, talk to you case manager.

4-4. MEDICAL TREATMENT EXPECTATIONS:

a. Mobilized Soldiers who are wounded, injured or become ill while on active duty will be treated for Service-connected and acute medical conditions. Most medical care will be provided through Army medical treatment facilities (MTF), but WTU Soldiers may also be referred to other military MTFs, or civilian or Veterans Health Administration (VA) providers and medical treatment facilities.

b. Soldiers with pre-existing, un-qualifying medical conditions identified within

the first 25-30 days of mobilization will be released from active duty (REFRAD) and returned to their home unit.

c. Soldiers with pre-existing, un-qualifying medical conditions not identified

within the first 25-30 days of mobilization will be offered treatment to make the Soldier medically qualified for deployment, or will be referred to the Physical Disability Evaluation System (PDES).

d. Soldiers with pre-existing, qualifying medical conditions that are aggravated

during mobilization will be treated as though the condition did not pre-exist mobilization.

e. Soldiers who cannot perform the duties and functions of MOS and grade after

reaching optimal therapeutic benefit (DoDI 1332.38), but who meet retention standards of medical fitness IAW AR 40-501 will be referred to a Medical/MOS Retention Board (MMRB) IAW AR 600-60, Army Physical Performance Evaluation System..

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f. Soldiers who reach optimal therapeutic benefit and do not meet retention

standards of medical fitness IAW AR 40-501 will be referred to the Physical Disability Evaluation System (PDES) IAW DoDI 1332.38.

g. The Army will offer active duty medical care until the Soldier reaches optimal

therapeutic benefit, or the course of treatment exceeds 365 days. After one year of treatment, Soldiers who do not meet retention standards of medical fitness IAW AR 40-501 will be evaluated for referral to the Physical Disability Evaluation System (PDES) IAW DoDI 1332.38. Medical care will continue while the Soldier is undergoing PDES processing.

h. All WTU Soldiers will be assigned a Primary Care Manager (PCM) and a

nurse Case Manager. The primary care manager (PCM) is a physician who directs and authorizes medical care and referrals for the Soldier. The case manager facilitates and coordinates medical care directed and authorized by the PCP. See paragraphs 4-2 and 4-3 for more information.

i. Patients may request a second medical opinion at the Army’s expense and at

the source of the Army’s choosing. This might be with another specialist or provider at your local Army MTF. The Deputy Commander for Clinical Services (DCCS), in consultation with the PCP, will determine the provider used for the second opinion.

j. Soldiers who desire a third opinion from someone of their own choosing (e.g.

civilian provider) may do so at their own expense. Military physicians are not obligated to concur with the assessment of civilian providers.

k. As an exception to TRICARE policy, the Office of The Surgeon General

(OTSG) has directed that mobilized Soldiers have priority for medical care at Army MTFs (for non-elective care):

(1) Initial primary care appointments and specialty care consultations within 72 hours

(2) Diagnostic studies (such as MRI) within one week (3) Surgery (from decision to actual surgery) within two weeks

NOTE: To meet these aggressive access standards, WTU Soldier may be scheduled as “walk ins” or “add-ons” so as not to disadvantage other patients with long-standing, scheduled appointments. Outside of Army MTFs, access to care standards follow established DoD or TRICARE standards.

l. WTU Soldiers are eligible for the same elective procedures (and access

priority) as other active duty Soldiers so long as:

(1) Elective procedures are available in the military MTF

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(2) Elective procedures do not interfere with Soldier’s medical treatment plan, can be done concurrently, and will not delay disposition, including PDES processing

(3) Elective procedures are scheduled and coordinated through the PCM

and case manager (4) Elective procedures are not used as justification for MRP orders or

extensions 4-5. PATIENT RIGHTS:

a. Medical Care: You have the right to quality care and treatment consistent with accepted standards and without discrimination. You have the right to express spiritual beliefs and cultural practices that do not harm others, and to actively participate with healthcare providers in the development of your treatment plan

. b. Respectful Treatment: You have the right to considerate and respectful care

with recognition of personal dignity and to participate in the discussion of ethical issues surrounding your care.

c. Privacy and Confidentiality: You have the right, within the law and military

regulations, to privacy and confidentiality concerning medical care. d. Identity and Information: You have the right to know the identity and

professional credentials of healthcare personnel, as well as the name of the healthcare provider primarily responsible for your care. You have the right to receive information about health plan options, providers and facilities, so you can make informed health care decisions.

e. Explanation of Care: You have the right to an explanation concerning your

diagnosis, treatment, procedures, and prognosis of illness in a language you can understand. When it is appropriate, information will be provided to next of kin or person you have designated.

f. Informed Consent: You have the right to the information necessary to enable you to make decisions about your care.

g. Research Projects: You have the right to be informed if the hospital proposes

to engage in or perform research associated with your care or treatment. You have the right to consent or refuse to participate in any research projects.

h. Safe Environment: You have the right to care and treatment in a safe

environment. i. MTF Rules and Regulations: You have the right to be informed of the rules

and regulations of the MTF that relate to you and your visitors. All military MTFs have no smoking policies. You can expect compliance with that policy from all. You have a right to information about the MTF’s procedure for

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resolving patient problems and concerns. You have the right, within published rules and regulations, to access information contained in your medical record.

j. End of Life Care: You have the right to direct the healthcare team on the extent of care you wish to receive through the use of advanced directives and communication with the healthcare team. Should you become unable to provide direction due to serious illness, you have the right to have your care directed and determined by your own advance directive, or by your designated decision-maker.

k. Issues/Concerns: You have the right, without recrimination, to voice

concerns regarding your care and to have those issues reviewed and resolved. You have a right to a fair, fast and objective review of any complaint you have against your healthcare treatment plan, your provider(s), access to care, conduct of healthcare personnel, or adequacy of healthcare services and facilities.

l. For a complete list of patient rights, see your local Army MTF.

4-6. PATIENT RESPONSIBILITIES: Providing quality healthcare is a complex

task that requires close cooperation between you and the healthcare team. Your responsibilities include:

a. Providing Information: You shall provide, to the best of your knowledge,

accurate and complete information about medical complaints, past illnesses, hospitalizations, medications, and other matters relating to your health. You have the responsibility to let your healthcare providers know whether you understand your treatment and what is expected of you.

b. Consideration: Be considerate of the rights of other patients and MTF staff.

You are responsible to respect staff, the property of other persons and the facility.

c. Following the Medical Plan: Follow your treatment plan, including follow-up

care recommended by your healthcare providers. This includes keeping appointments on time and notifying the MTF when appointments cannot be kept. You are in partnership with your healthcare team and are a major contributor to your well being and state of health.

d. Medical Records: When transporting your medical records, ensure the prompt return of your records to the MTF. All military medical records are the property of the US Government. DoD has instituted a closed medical record system that normally does not allow Soldiers to hand-carry their medical records. If granted the responsibility of hand-carrying medical records as an exception to policy, it is imperative that compliance with HIPAA, AR 40-66 and other rules are strictly enforced. Note: Any “modification” of your medical record (including removal of any document) constitutes falsification of official records and is punishable under the UCMJ.

e. MTF Rules and Regulations: Please follow all MTF rules and regulations.

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f. Reporting of Issues: To help the MTF Commander provide the best possible

care to all beneficiaries, please report any care problems or concerns to the unit officer in charge (OIC), the noncommissioned officer in charge (NCOIC) or contact the Patient Advocacy Office located in the MTF.

4-7. MAINTENANCE OF MEDICAL RECORDS: Army health records (HREC),

including medical inpatient and outpatient records and dental records, are the property of the US Government, and are subject to the same controls that apply to any Government documents. Additionally, the Assistant Secretary of Defense for Health Affairs (ASD (HA)) has established a closed HREC system for the Military Health System (MHS). The HREC is the Government’s documentation of the health care that is has rendered and shall be protected. Thus, Soldiers may not normally have possession of their HREC.

a. Army health records will remain in the custody of the Army medical treatment

facility (MTF) or dental treatment facility (DTF). HRECs generated for mobilized RC Soldiers will also remain in the custody of the MTF or DTF for the duration of the mobilization. HREC for RC Soldiers in Reserve status will remain in the custody of the appointed RC custodian.

b. Soldiers are required to in-process and turn in medical records to the

designated Patient Administration Division (PAD) section at your local MTF or health clinic. At the time of release from MRP status, Soldiers are required to out-process through PAD medical records section. Soldiers who were hospitalized at any point during their WTU stay shall sign a “release of medical records” statement to have the inpatient medical records sent to the medical record custodian of the Soldier’s home unit. Your case manager or PAD representative can assist you in obtaining this release form. Soldiers desiring a copy of their records will need to sign a release of records form and a copy of the medical records will be mailed to them. The local PAD office can tell you about how long it will take to get your records copied and mailed. If a Soldier is undergoing physical disability processing, the medical records will be maintained by the MEB section of PAD. NOTE: If you are separating from the Army, ask that your original HREC be sent directly to the Department of Veterans Affairs (VA) for rating from the transition point. This will expedite your access to VA benefits

4-8. MEDICAL NON-COMPLIANCE:

a. Non-compliance with medical treatment plans is watched closely by the WTU cadre. Non-compliance includes being a “no show” for scheduled appointments, frequent cancellation of appointments with rescheduling in order to delay medical care, failure to pick up and take prescribed medications, and knowingly violating physical profiles and provider’s medical recommendations. Soldiers are expected to accept the earliest surgery or procedure appointment date offered. Failure to comply with your medical treatment plan may result in your release from Medical Retention Processing (MRP) status. Failure to show for any scheduled appointments may result in disciplinary action IAW UCMJ.

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b. Appointment “no shows”: Failure to keep scheduled medical appointments

not only constitutes “failure to appear”, but also demonstrates a lack of consideration and respect for fellow Soldiers and healthcare beneficiaries. At military MTFs, “no shows” constitute a waste of precious medical resources (access to care) that result in increased waiting times for future appointments for all patients. In civilian MTFs, a small number of “no shows” can result in the MTF closing access for all Soldiers and beneficiaries in that community. Therefore, the Command takes “no shows” very seriously, and Soldiers can expect that aggressive Command action will follow.

4-9. HEALTH INSURANCE PORTABILITY & ACCOUNTABILITY ACT

(HIPAA): The Health Insurance Portability and Accountability Act (HIPAA) of 1996 is a Federal law that became effective in 2004. Except as noted in para c below, the military services shall comply with this law, as well as all civilian and VA medical treatment facilities. Civilian MTFs that are not familiar with the military exclusion might understandably refuse to release protected health information (PHI) to Commanders. The C2 and medical members of the care team shall work together to ensure they have the necessary PHI to properly manage their WTU Soldiers, and will ensure that PHI is not released to individuals who have no need to know.

a. HIPAA Privacy Rule: The HIPAA Privacy Rule institutes business processes

to protect the use and disclosure of protected health information (PHI). PHI is individually identifiable health information, including demographics, in paper, electronic, or oral form. PHI is not limited to the documents contained in the official medical record. The HIPAA Privacy Rule allows the use and disclosure of PHI for treatment, payment and health care operations without written authorization from the patient. Other uses and disclosures require permission.

b. HIPAA Security Rule: The HIPAA Security Rule is designed to provide

protection for all individually identifiable health information that is maintained, transmitted or received in electronic form – not just the information in standard transactions.

c. Military Exclusion: The Health and Human Services (HHS) HIPAA Privacy

Rule gives the Department of Defense authority to disclose to Commanders (without the need for authorization) the protected health information of Armed Forces personnel for certain purposes, including Line of Duty or Medical Boards, Specific information regarding HIPAA Privacy and Security can be found on the TRICARE Management Agency (TMA) Privacy Office Web site at www.tricare.osd.mil/tmaprivacy.

d. HIPAA for WTU Soldiers: Individuals may release their own health

information to whomever they choose. However, except for the military exclusion, others cannot release this information without your permission. You will be asked repeatedly to sign HIPAA release forms so that your providers and nurse case managers can properly provide report and coordinate your medical care. Failure to sign HIPAA release forms can result

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in refused services at medical treatment facilities. Therefore, Soldiers are expected to sign HIPAA release forms so that your medical evaluation and treatment can proceed smoothly and immediately. Refusal to authorize disclosure of PHI to your health care team may result in release from active duty, as your health care team will be unable to provide appropriate medical care without this information. HIPAA provides for significant personal civil and criminal liability for unauthorized release of patient information. Do not discuss other Soldiers’ medical conditions and treatment without their permission. EXCEPTION: If you have reason to believe that a Soldier might harm himself or others, it is your duty to report this information immediately to the appropriate authorities (usually chain-of-Command).

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CHAPTER 5: MEDICAL HOLDOVER (MHO) OPERATIONS 5-1. MEDICAL HOLDOVER (MHO) OPERATIONS: Medical Holdover (MHO)

operations began in 2003 as large numbers of Reserve Component (RC) Soldiers were mobilized in support of Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF). As the population of mobilized Soldiers in need of medical evaluation and treatment rose, the Army established accelerated access standards, dedicated providers and case managers, new Command and control (C2) and installation support structure, and other provisions to support these reserve component Soldiers while on active duty. The term, Medical Hold Over (MHO), was coined to define this population of mobilized RC Soldiers on Title 10 active duty orders. Recently, the term Warrior in Transition (WT) has been developed to describe both reserve component and active component Soldiers who are unable to perform their military duties because of illness or injury and are receiving medical care and treatment for those conditions. The reserve component WT Soldiers are diverted from their normal mobilization mission [or any contingency operation] because of new or aggravated pre-existing medical conditions because of being mobilized. Soldiers can become WT either pre-deployment or post-deployment, including via medical evacuation. The statutory authority for these Soldiers to remain on active duty falls under two sections of Title 10:

a. Soldiers with greater than 120 days remaining on their MOB orders and

medical care anticipated to require no more than 60 days remaining on their mobilization orders under 10 USC 12302.

b. Soldiers with less than 120 days remaining on their MOB orders or whose

medical care is anticipated to require more than 60 days may volunteer to convert to Medical Retention Processing (MRP) orders under 10 USC 12301(h). The majority of WT Soldiers have converted to MRP orders. See paragraph 5-3 for more specific information.

5-2. ENTRY INTO WTU & MRP STATUS: Soldiers shall volunteer if they desire

to remain on active duty (AD) for medical treatment and convert to medical retention processing (MRP) orders. Those individuals who decline to remain on AD on MRP orders will sign a declination statement and will be released from active duty (REFRAD).

a. The 25-Day Rule: Soldiers found to be medically unqualified for deployment

within the first 25 days of mobilization due to pre-existing conditions will be released from active duty (REFRAD) and returned to home station no later than 30 days from mobilization date. These non-deployable Soldiers revert to their pre-mobilization reserve status. If the medical condition is temporary (e.g., simple fracture) and the Soldier recovers, no further action is required, and the Soldier again becomes eligible for mobilization. If the Soldier does not or might not meet medical retention standards IAW AR 40-501, the RC Commander is required to initiate physical fitness determination processes (MMRB, non-duty PEB, etc.) through the Army Physical Performance

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Evaluation System (PPES) IAW AR 600-60 or the Physical Disability Evaluation System (PDES) IAW AR 635-40 and DoDI 1332.38.

b. Pre-Deployment (after 30 days of mobilization):

(1) Soldiers who are not expected to return to duty (RTD) within 60 days

are re-assigned on MRP orders to the Warrior Transition Unit /Medical Retention Processing Unit (MRPU) or are REFRAD if Soldier signs a declination statement.

(2) Soldiers who are expected to return to duty (RTD) within 60 days will

remain on their mobilization orders, but are attached to the WTU/MRPU (or MTF, if inpatient) until they are medically cleared to return to their unit.

c. Medical Evacuation from Combat Theater or OCONUS Deployment:

(1) Soldiers who are not expected to return to duty within 60 days or have

less than 120 days remaining on their mobilization orders are re-assigned on MRP orders to the WTU/MRPU or are REFRAD if Soldier signs declination statement.

(2) Soldiers who are expected to return to duty within 60 days and have

more than 120 days remaining on their mobilization orders will remain on their mobilization orders, but are attached to the MRPU (or MTF, if inpatient) until medically cleared for demobilization.

d. Re-deployment from Combat Theater or OCONUS Deployment:

(1) Soldiers who are not expected to return to duty within 60 days or have

less than 120 days remaining on their mobilization orders are re-assigned on MRP orders to the WTU/MRPU or are REFRAD if Soldier signs declination statement.

(2) Soldiers who are expected to return to duty within 60 days and have

more than 120 days remaining on their mobilization orders will remain on their mobilization orders, but are attached to the WTU/MRPU (or MTF, if inpatient) until medically cleared for demobilization.

e. Declination of Medical Retention Processing (MRP) Orders:

(1) Soldiers who are re-deploying, or approaching the end of their

mobilization or current MRP orders may decline to remain on active duty to complete medical evaluation and treatment. Soldiers will indicate their decision to decline by signing a declination statement. NOTE: Physical performance evaluation or disability processing will continue regardless of Soldier’s duty status decision.

(2) Upon REFRAD, mobilized Soldiers might be authorized medical care

under several programs:

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(a) DoD and VA medical treatment facilities (MTF): Soldiers

with approved LODs (DA Form 2173, Statement of Medical Examination and Duty Status) are authorized medical care for those documented medical conditions at military or VA medical treatment facilities (MTF). Soldiers might also be eligible for care at VA MTFs depending on the disability discharge status documented on their DD Form 214, Certificate of Release or Discharge from Active Duty.

(b) TRICARE: All mobilized Soldiers are eligible for TRICARE’s

Transition Assistance Management Program (TAMP) for 180 days from the date of REFRAD. Soldiers may also participate in TRICARE through the TRICARE Reserve Select program. See your TRICARE Service Center (TSC) or go to www.tricare.osd.mil for more information on these programs. NOTE: After REFRAD, RC Soldiers are eligible for TRICARE Standard only, which results in higher out-of-pocket expenses than the active duty TRICARE Prime option.

f. Physical Profile (DA Form 3349):

(1) WTU Soldiers shall have an approved Physical Profile (DA Form

3349) that describes their functional limitation(s). WTU Soldiers shall carry their profiles whenever they are in uniform or on duty.

(2) Profiles can be either temporary or permanent. Soldiers might require

both a temporary and permanent profile. All physical limitations shall be annotated on the DA Form 3349.

(3) Soldiers are responsible for adhering to the limitations of their profile.

Intentional violation of an approved physical profile can affect the outcome of LOD determinations. If a Soldier is asked to violate his profile by a supervisor or senior NCO, he should report it through his chain-of-Command to his Commander or 1SG.

(4) Soldiers with permanent 3 or 4 profiles that meet medical retention

standards IAW AR 40-501 will be referred to a Medical/MOS Retention Board (MMRB) IAW AR 600-60. Active duty Soldiers who do not meet medical retention standards will be referred directly to a Medical Evaluation Board (MEB) IAW AR 40-400.

(5) Physical Profile Functional Capacity:

(a) PULHES factor: P – physical capacity, U – upper

extremities, L – lower extremities, H – hearing/ears, E – vision/eyes, S – psychiatric.

(b) Profile serial code: 1 – no limitations; 2 – minor limitations,

does not significantly impact duty; 3 – moderate limitations,

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some impact on duty; 4 – severe limitations, definite impact on duty.

5-3. MEDICAL RETENTION PROCESSING (MRP):

a. The Medical Retention Processing (MRP) policy established 10 USC 12301(h) as an alternative statutory authority to allow mobilized Soldiers to remain on active duty for medical care and treatment in lieu of mobilization orders. Unlike the previously established Active Duty Medical Extension (ADME) program, Soldiers on MRP orders retain their mobilization benefits upon REFRAD or separation; that is, timelines for demobilization benefits start at the time of REFRAD or separation and not when Soldiers come off mobilization orders. Eligibility for MRP orders is based solely on standards of medical fitness for duty and by law cannot consider whether Soldiers can perform their civilian jobs.

b. Conversion to MRP orders is voluntary. Eligible WT Soldiers shall be

counseled in writing by qualified personnel (preferably a team representing both the medical and Command and control (C2) communities) about converting to MRP orders, including the benefits and disadvantages for the individual Soldier. Soldiers who choose to convert from mobilization orders to MRP orders will be reassigned to a WTU Command and control (C2) unit, either an on-installation WTU/Medical Retention Processing Unit (MRPU) or an off-installation Community-Based Health Care Organization (CBHCO). Upon voluntary conversion to MRP orders, Soldiers will remain on active duty until their orders expire (179 days) or until optimal therapeutic benefit (OTB) or disposition is achieved if less than 179 days. Upon publication of MRP orders, Soldiers do not have the option to decline MRP. These same rules apply for MRP extensions.

c. Declination of MRP orders. Soldiers on mobilization orders may decline

conversion to MRP orders and will be released from active duty (REFRAD). Following individual written counseling on the benefits and disadvantages of volunteering for MRP orders, Soldiers who choose to REFRAD will sign a MRP declination statement. These Soldiers may obtain follow-up care through the Transition Assistance Management Program (TAMP) [see www.tricare.osd.mil for more info] or Department of Veterans Affairs (VA) benefits.

d. Application for MRP orders. Soldiers who choose to convert to MRP orders

shall submit a request for Personnel Action (DA Form 4187) requesting conversion to MRP orders. To apply, Soldiers require a preliminary medical evaluation and valid Physical Profile (either temporary or permanent) that describes their functional limitations. Medical profiling officers shall indicate whether the medical problem can be resolved within 60 days.

e. MRP orders: MRP orders will be effective for up to 179 days after the

effective start date unless sooner revoked or extended. AW2 Soldiers may be

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placed on initial 365 day orders. Each MRP extension adds 179 days. Soldiers on MRP orders who anticipate the need and desire to extend should coordinate with their MHO team 60 days prior to expiration of orders. The WTU/MRPU or CBHCO shall submit extension requests 45 days prior to the expiration of their current orders. MRP orders are published by Human Resources Command-Alexandria (HRC-A) and assign Soldiers to a WTU Command and control unit, either MRPU or CBHCO. Upon conversion to MRP orders, the Soldiers’ pay and allowances fund cite changes. It is imperative that Soldiers carefully monitor MyPay to detect and fix any pay problems early on.

f. Involuntary Termination of MRP orders: In rare instances in which Soldiers

persistently violate the MRP rules of engagement and/or abdicate their responsibilities in support of their treatment plan, Soldiers may be involuntarily terminated from MRP orders, and subsequently REFRAD or separated.

5-4. MEDICAL RETENTION PROCESSING 2 (MRP2):

a. The Medical Retention Processing 2 (MRP2) program allows previously mobilized and REFRAD Soldiers to return to active duty to address medical problems that were unresolved at the time of REFRAD/demobilization.

b. Soldiers are eligible to apply for MRP2 for up to six (6) months following

REFRAD. c. The Soldier’s home unit is responsible for assisting Soldiers in preparing and

submitting their MRP2 application packet. MRP2 application packets will be administratively cleared by HRC-A, and forwarded to the OTSG MRP2 Medical Review Board. The Medical Review Board consists of medical officers representing the Active Component, ARNG and USAR. The board reviews all MRP2 application packets and makes its recommendation based on sufficiency of medical documentation to support the Soldier’s return to active duty for treatment. Medical documentation may be a compilation of military and civilian medical records.

d. Soldiers who are not eligible for MRP2 include:

(1) Soldiers discharged or separated from the Army

(2) Soldiers in the Active Guard and Reserve (AGR)

(3) Soldiers whose medical condition(s) pre-existed or were not aggravated by mobilization

(4) Soldiers with “Line of Duty (LOD) – No” determinations

(5) Soldiers in an approved Continuation On Active Reserve (COAR)

status

(6) Pregnancy might preclude selection for MRP2

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e. Soldiers may decline MRP2 up to the time that MRP2 orders are published.

If the Soldier is eligible and wishes to withdraw his/her MRP2 application, the Soldier shall sign a MRP2 declination statement. Soldiers may decline without prejudice prior to the publication of MRP2 orders.

f. Soldiers on MRP2 orders will be assigned to and report to an Army

installation where they will undergo medical evaluation and development of a treatment plan. MRP2 Soldiers might be eligible for transfer to a CBHCO under the same eligibility and selection criteria used for MRP Soldiers.

5.5. COMMUNITY-BASED HEALTH CARE ORGANIZATION (CBHCO):

a. The Community-Based Health Care Organization (CBHCO) is a WTU operations program established to leverage community resources to expand Army installation housing and medical care capacities. The CBHCO is a company-level Command, that provides Command and control, administrative support, and medical coordination and case management for Soldiers on MRP orders assigned to a WTU and further attached to the CBHCO. The CBHCO allows WT Soldiers to return to their families and communities, and receive medical treatment from locally available and TRICARE-approved providers while recuperating at home.

b. All Soldiers assigned to the WTU on MRP orders will be assessed by the

installation WTU team (C2 and medical cadre) for potential referral to a CBHCO. Soldiers who are referred to a CBHCO will be evaluated by the CBHCO cadre (C2 and medical) for acceptance. Transfer to a CBHCO is based on established eligibility and selection criteria that include:

(1) Soldier requires medical treatment that exceeds 60 days. (2) Soldier is unencumbered by legal or administrative action or holds, to

include flags or pending chapter action. (3) Soldier’s medical needs can be managed by the CBHCO using

community resources within commuting distance from home (generally 50 miles or 1 hour). Note: Soldiers may travel on TDY orders (DD Form 1610, Request and Authorization for TDY Travel of DoD Personnel) for occasional specialty consultation or follow-up, as determined by the medical cadre, IAW established TMA/OTSG procedures.

(4) Soldier shall have an adequate place to live with a mailing address,

telephone, and accommodations for physical limitations. (5) Soldier is able to perform duty in support of Title 10 mission

commensurate with rank and skills at a Federal or state facility within commuting distance from home (generally 50 miles or 1 hour).

(6) Soldier has access to reliable transportation to and from medical

appointments and assigned duty location.

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(7) Soldier’s military primary care and specialty providers agree that the

CBHCO setting is appropriate for treatment and optimization of medical conditions, and will not unduly delay medical disposition. Not all medical conditions can be appropriately managed outside of a military medical treatment facility (MTF).

(8) Soldiers who reside within the catchment area of an Army medical

treatment facility (MTF) may be eligible for transfer to a CBHCO, if a WTU/MRPU is not present on the supporting installation.

. c. The Army will decide whether a WTU Soldier remains on-installation or is

transferred to a CBHCO. Soldiers may communicate their preference and any other factors to be considered, such as local housing contracts, change in home environment, disruption of care concerns, etc., which might affect the decision. Soldiers may not refuse transfer to a CBHCO. NOTE: In general, Temporary Change of Station (TCS) orders for mobilized RC Soldiers are legally sufficient to invoke the military clause on rental agreements.

d. CBHCOs perform many installation functions including Command and control, processing of personnel actions, processing of pay actions, case management, medical appointment scheduling, medical case review, initiation of medical evaluation boards (MEB), mental health assessments and referrals, etc. However, CBHCOs depend on installation support for activities that exceed their scope and capabilities. The Installation Management Command (IMCOM) has established support relationships between the CBHCOs and selected Army installations for garrison activities. Medical support will follow established MEDCOM and Regional Medical Command lines of responsibility.

e. Soldiers selected for transfer to a CBHCO will remain assigned to the WTU at the losing installation. HRC-A will publish orders attaching the Soldier to the CBHCO with their residence listed as the end destination. Soldiers will out-process from the losing installation prior to travel. Out-processing should include completion of worksheet for DD 214, Certificate of Release or Discharge from Active Duty, resolution of pay problems, required ACAP pre-separation briefing, and completion of the MHO out-processing checklist established by OTSG/MEDCOM. Soldiers will travel on TDY orders (DA Form 1610, Request and Authorization for TDY Travel of DoD Personnel) from the installation to the CBHCO for in-processing, and then to their residence. Pass or leave in conjunction with transfer to CBHCO is not authorized.

f. There are currently eight (8) regional CBHCOs throughout CONUS, and three

(3) OCONUS WTUs (Alaska, Hawaii and Puerto Rico) that integrate on- and off-installation WT operations. [Refer to map below for specific regional areas.]

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Slide 26COL Baker\DASG/(703) 681-3249 (DSN 761) / rebecca.baker@us.army.mil UNCLASSIFIED

CBHCO HQ and Regions

PR

CBHCO HQ

AK

HI

* AK, HI and PR to run CBHCO-like operations from local garrisons & MTFs

WI CBHCORock Island, IL

MA CBHCOConcord, MA

VA CBHCOVA Beach, VA

FL CBHCOOrlando, FL

AL CBHCORedstone Arsenal, AL

UT CBHCOSLC, UT

AR CBHCOLittle Rock, AR

CA CBHCOSacramento, CA

g. CBHCO cadres manage their WT Soldiers primarily through telecommunications and other long-distance strategies. To mitigate the lack of face-to-face communication, the CBHCO will establish regular accountability and management communication:

(1) The CBHCO platoon sergeants talk to their WT Soldiers on a daily

basis to provide accountability and to ensure the well-being of their Soldiers. It is imperative that platoon sergeants get to know their WT Soldiers so they can serve as the first line of defense if Soldiers develop mental health, personal or other problems. Platoon sergeants maintain communication logs.

(2) Case managers contact their WT Soldiers at least weekly to assess medical progress. Case managers document their encounters in the Soldiers’ health record.

(3) Work place supervisors may assist platoon sergeants and case

managers to accomplish above responsibilities, but their assistance does not eliminate the requirement for daily and weekly contact as described above.

h. Soldiers shall make satisfactory medical progress and remain in good

disciplinary standing to remain attached to the CBHCO. Developments that could result in Soldier’s transfer back to the installation include:

(1) Unsatisfactory medical progress, lack of available medical resources,

new medical problems that increase case complexity (2) Non-compliance with WT/CBHCO rules or treatment plan

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(3) Change in Family situation, loss of residence, or loss of transportation (4) Disciplinary problems or UCMJ violation committed by Soldier

CHAPTER 6: PHYSICAL DISABILITY PROCESSING 6-1. PERMANENT PROFILES: Permanent physical profiles (DA Form 3349,

Physical Profile) will be written and approved IAW AR 600-60, paragraph 2-6, Issuance of Permanent Profile: When issuing a permanent 3 or 4 profile, medical profiling officers should determine if the Soldier meets the medical retention standards of AR 40-501. Soldiers who do not meet medical retention standards bypass the MMRB and are referred directly into the PDES. (See paragraph 5-2f for more information on profiles and WT requirements.).

6-2. LINE OF DUTY (LOD):

a. Lines of duty (LOD) determinations are essential for protecting the interests of both the individual Soldier and the US Government when military service is interrupted by injury, disease, or death. Army policy requires that Soldiers who are injured or wounded, aggravate pre-existing injuries, or acquire certain diseases while on active duty have a line of duty (LOD) determination made. Informal lines of duty are documented and approved on a DA Form 2173, Statement of Medical Examination and Duty Status. Formal line of duty investigations and findings are documented on the DD Form 261, Report of Investigation – Line of Duty and Misconduct Status.

b. To ensure Soldiers receive appropriate medical care after leaving active duty,

unit Commanders are responsible for initiating and completing LOD investigations. Investigations can be conducted informally by the chain-of-Command, or formally, where an investigating officer is appointed to conduct an investigation into suspected misconduct or negligence. The chain-of-Command will initiate the DA Form 2173, Statement of Medical Examination and Duty Status, and complete Section II; the health care provider will complete Section I. “Line of duty – no” determinations will be made only after a formal investigation. The LOD is approved when signed by the appointing authority. NOTE: For Soldiers with obvious combat injuries, the Army presumes the injury incurred in the line of duty absent evidence to the contrary, and an investigation is not required. If the Soldier does not already have an LOD (DA Form 2173 or DD Form 261) from his theater unit or previous military MTF, the current Commander is responsible for initiating one.

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c. Current Army policy does not require a line of duty for Soldiers undergoing the PDES process in which documentation from the medical records and PDES forms may be used in lieu of an LOD. However, it is strongly recommended that Soldiers who might require follow-up care ensure they have an approved LOD to present at military or VA medical treatment facilities. Additionally, an approved LOD is required when applying for INCAP pay.

d. Line of duty determinations are not normally made for pain alone. Pain can

be included in an LOD determination when it relates to a documented injury or other medical condition.

e. Line of duty determinations for Post Traumatic Stress Disorder (PTSD) follow

the DoD definitional guidelines of a chronic disorder, and are not commonly seen on LODs. LODs are more likely to list a more acute diagnosis such as normal stress reaction, situational stress reaction, acute stress reaction, etc.

f. In addition to prescribed distribution of approved LOD (DA Form 2173), a

completed copy of LOD documentation will be distributed to the following:

(1) Individual Soldier

(2) Soldier’s OMPF and field personnel file

(3) Soldier’s medical record

(4) Soldier’s home unit

g. Soldiers who incur or aggravate an injury, illness or disease while on active duty that is determined by the Department of Veterans Affairs (DVA or VA) to be service-connected are eligible for medical care through the Veterans Health Administration (VHA or VA) for the rest of their lives for that condition or conditions. Severely disabled Soldiers might also be eligible for medical care for all medical conditions, even those not service-connected. An approved LOD (DA Form 2173) is an important piece of evidence used by the VA to determine service connection. NOTE: Most VA medical treatment facilities (MTF) require that Soldiers present an approved LOD when requesting care at their facilities.

h. A Soldier who incurs an injury or illness because of his or her intentional

misconduct or willful negligence stands to lose substantial benefits because of his or her actions. It is very important, therefore, that Soldiers consider the impact of alcohol and drug use and unlawful behavior on line of duty outcomes. An adverse line of duty finding can have far-reaching impacts to include forfeiture of pay, loss of disability retirement or severance pay and loss of benefits with the VA.

6-3. PHYSICAL PERFORMANCE EVALUATION SYSTEM (PPES) The

Army Physical Performance Evaluation System (PPES) functions to maintain the quality of the force by ensuring that Soldiers are physically qualified to perform their primary military occupational specialty (PMOS) or specialty code worldwide and

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under field conditions. The PPES (AR 600-60) is a program designed to evaluate Soldiers who have been issued a permanent Physical Profile with a numerical designator of three (3) or four (4) under any physical profile serial code (PUHLES) factor of the physical profile to determine if they have the physical ability to satisfactorily perform their primary MOS worldwide and in a field environment. The PPES establishes the Medical/MOS Retention Board (MMRB) as the administrative screening board to make this determination.

6-4. MEDICAL/MOS RETENTION BOARD (MMRB)

a. Soldiers with a permanent 3 or 4 profile will be referred to a Medical/MOS Retention Board (MMRB) IAW AR 600-60, Physical Performance Evaluation System, paragraph 2-2 and 2-3, to determine if they meet MOS retention standards (reference DA Pam 611-21, Military Occupational Classification and Structure). NOTE: Soldiers who do not meet medical retention standards IAW AR 40-501, Standards of Medical Fitness, will be referred directly into the Physical Disability Evaluation System (PDES) to a Medical Evaluation Board (MEB) or non-duty Physical Evaluation Board (PEB), as applicable.

b. The purpose of the MMRB is to determine if Soldiers are medically qualified

to perform in their MOS. DA Pam 611-21 describes the PULHES standards for initial entry to grade and MOS (for example, 11B PULHES 111221), which may be used as an indicator of the physical ability required to perform in a specific MOS. Soldiers have the right to appear before the board or to ask someone to appear on their behalf.

c. The MMRB will recommend one of four actions based on the Soldier’s case

presentation and discussion:

(1) Retain in currently assigned MOS (2) Reclassify to another MOS IAW DA Pam 611-21 and Army MOS

needs

(3) Refer to PDES (MEB or non-duty PEB, if applicable)

(4) Table board action for up to 6 months if Soldier’s medical condition might change

d. Soldiers shall provide a written rebuttal within two (2) working days after the

board adjourns and Soldier has been notified of MMRB results. 6-5. PHYSICAL DISABILITY EVALUATION SYSTEM (PDES): is the

Department of Defense (DOD) program for determining the physical fitness or unfitness of individual Soldiers for military duty IAW the established standards of medical fitness (AR40-501). The PDES is also responsible for determining the degree of disability, if any, and compensation for disability if applicable. The following is a link to the Physical Disability Evaluation System or PDES website that

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provides comprehensive information on PDES: https://www.hrc.army.mil/site/Active/TAGD/Pda/pdesystem.htm. There is also a separate handbook on PDES for the individual Soldier available though the WTU. The handbook addresses the Medical Evaluation Board (MEB), the Informal Physical Evaluation Board and the Formal Evaluation Board (PEB).

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CHAPTER 7: TRANSITION 7-1. TRAUMATIC-RELATED STRESS:

a. Stress is part of daily living. Soldiers might experience stress meeting MOS demands, adjusting to a new environment, dealing with Family disruption and changes in health or developing new friendships. Stress is not necessarily harmful and mild forms of stress can act as a motivator and energizer. However, medical and social problems may result if stress levels are too high. Let your nurse case manager know how you are feeling. Every MTF has licensed Behavioral Health care staff available to work with any Soldier who requests assistance.

b. The interpretation and reaction to external events determines stress levels.

People respond dramatically different to the types of events they interpret as stressful.

c. There are several signs and symptoms that you may notice when you are

experiencing stress. These signs and symptoms fall into four categories: feelings, thoughts, behavior, and physiology. When you are under stress, you may experience one or more of the following:

(1) Feelings: Anxious, scared, irritable, and moody. (2) Thoughts: Low self-esteem, fear of failure, inability to concentrate,

embarrassing easily, worrying about the future, preoccupation with thoughts/tasks.

(3) Behavior: Stuttering and other speech difficulties, crying for no

apparent reason, forgetfulness, acting impulsively, startling easily, laughing in a high pitch and nervous tone of voice, grinding your teeth, increasing smoking, increasing use of drugs and alcohol, becoming accident-prone, losing your appetite or overeating.

(4) Physiology: Perspiration/sweaty hands, increased heart rate,

trembling, nervous ticks, dryness of throat and mouth, tiring easily, urinating frequently, sleeping problems, diarrhea/indigestion/vomiting, butterflies in stomach, headaches, premenstrual tension, pain in your neck or lower back, loss of appetite or overeating, increased susceptibility to illness.

d. Normal signs and symptoms of combat stress include: empting bowels and

bladder during times of danger; fatigue and/or weariness; distant, haunted “1000 yard” stare; anxiety, excessive worrying, irritability, swearing, and complaining; frequently awakened by bad dreams; grieving; feeling guilty; anger at one’s own team; losing confidence in self/unit.

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e. Both positive and negative events in one’s life can be stressful. However, major life changes are the greatest contributions of stress for most people. They place the greatest demand on resources for coping. Major life changes that can be stressful include: geographic mobility, learning a new trade, career changes, new job, marriage, pregnancy, new life style, divorce, death of a loved one or colleague, being fired from your job, or being chaptered out of the military.

f. Environmental events that can be stressful include: time pressure,

competition, financial problems, noise, and disappointments.

g. Many stressors can be changed, eliminated, or minimized. Here are some things you can do to reduce your level of stress:

(1) Become aware of your reactions to stress. (2) Reinforce positive self-statements. (3) Focus on your good qualities. (4) Avoid unnecessary competition. (5) Avoid drugs and alcohol. (6) Develop assertive communication and behaviors.

(7) Recognize and accept your limits. Remember, everyone is unique

and different. (8) Develop a hobby or two. Relax and have fun. (9) Exercise regularly, if you are able to do so. (10) Eat nutritious food. (11) Talk with friends or someone you can trust about your worries and

concerns. (12) Learn to use your time wisely:

(13) Evaluate how you are budgeting your time.

(14) Plan and avoid procrastination

(15) Make a weekly/monthly schedule and try to follow it.

(16) Set realistic goals.

(17) Set priorities.

(18) Practice relaxation techniques

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h. Military One Source is a program that has transitioned from Army One Source and will assist Soldiers with any issues they may be experiencing. Some issues may include buying a new car, preparing for deployment or reunions, finances, relationships or having someone available just to chat. Master consultants are available 24/7 at 1-800-342-9647 or at www.militaryonesource.com.

7-2. DEPARTMENT OF VETERANS AFFAIRS (DVA or VA): The

Department of Veterans Affairs (DVA or VA) offers a wide range of Federal benefits for current and former military service members and their families. The Department administers its programs primarily through two administrations: (1) Veterans Health Administration (VHA) and (2) Veterans Benefits Administration (VBA). For more information about specific benefits, visit the nearest VA regional office; go to www.va.gov, or call-1-800-827-1000. All Soldiers are required to attend VA benefit briefings and will be given duty time to apply for benefits. Soldiers are urged to become educated about VA programs and apply for benefits for which they are eligible.

a. Veterans Health Administration (VHA or VA): Veterans shall enroll to receive

VA health care benefits. When they enroll, veterans are placed in priority groups or categories that help the VA manage access to quality health care services. Veterans exempted from enrollment requirement include: veterans discharged from the military within one year who have not yet been rated for VA disability benefits, veterans seeking care only for service-connected disabilities, and veterans with service-connected disability of 50 percent or more. Veterans with combat injuries and service-connected disabilities receive priority access to care for hospitalization and outpatient care. NOTE: The VA will provide combat veterans free medical care for any illness associated with service during a period of hostility for 2 years from the veteran’s release from active duty (REFRAD). To facilitate better planning of health care resources, however, these veterans are also urged to enroll. For more information go to www.seamlesstransition.va.gov or call 1-877-222-8387 or see page 8 of the Department of Veteran Affairs, 2005 Edition, Federal Benefits for Veterans and Dependents.

b. The VA’s Readjustment Counseling Service operates 207 Vet Centers that

provide readjustment counseling and outreach services for war-related trauma (including sexual assault) to all veterans who served in any combat theater or area of armed hostility. Services are also available for their Family members for military-related issues. The goal of Vet Centers is to help Soldiers and their families make a satisfying transition from military to civilian life. These services are provided at no cost to the veteran or the Family. Small multi-disciplinary teams of dedicated providers, many of whom are combat veterans themselves, staff the Vet Centers. Vet Center staff is available toll free during normal business hours at 1-800-905-4675 (Eastern) and 1-866-496-8838 (Pacific).

c. Veterans Benefits Administration (VBA or VA): The VBA is responsible for

rating veterans’ disabilities IAW the Veterans Administration’s Schedule for

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Rating Disabilities (VASRD). Eligibility for other VA benefits (including health care, compensation, and vocational rehab) can vary based on the veteran’s disability rating. Apply for compensation, pension, health care, education, or vocational rehab and employment by selecting “Apply Online” at www.va.gov.

d. The Vocational Rehabilitation and Employment program helps veterans who

have service-connected disabilities to prepare for, find and keep suitable employment. The VA also provides services to assist veterans with serious disabilities to live as independently as possible. For more information, go to www.vetsuccess.com.

e. Benefits Enrollment with the VA: Most Army installations have a VA benefits

counselor on site or regularly scheduled to provide briefings and assist Soldiers in applying for benefits. WTU Soldiers are required to attend VA benefits briefings and will be given duty time to apply for VA benefits. To facilitate better planning of financial matters, job assistance, and health care services, all veterans are urged to apply for benefits.

f. Documents needed to apply for health care services:

(1) DD Form 214, Certificate of Release or Discharge from Active Duty (2) DA Form 2173, Statement of Medical Examination and Duty Status (3) Original medical records (or copy, if not separating) stating extent of

injury, illness and/or disease. [NOTE: When separating from the Army, ask the Transition Center to send your original medical records directly to the VA. This will expedite VA disability rating.]

(4) Copy of Leave and Earning Statement (LES) displaying receipt of

hostile fire or imminent danger pay, proof of exemption from Federal tax status for hostile fire or imminent danger pay, or orders to a theater of combat operations.

7-3. ARMY CAREER & ALUMNI PROGRAM (ACAP)

a. The Army Career and Alumni Program (ACAP) is a congressionally mandated program that provides transition and career counseling services to eligible DoD personnel departing Federal service. WTU Soldiers may begin participating in ACAP activities at any time.

b. One of the services provided by ACAP is the pre-separation briefing. The

pre-separation briefing is a mandatory briefing for all military personnel who are leaving active (Title 10) duty regardless of the reason (release from active duty (REFRAD) or separation). Soldiers are required to attend the pre-separation briefing and complete the Pre-separation Counseling Checklist (DD Form 2648) no less than 90 days before leaving Federal service. You will not be able to clear the installation until you complete these two requirements. (NOTE: REFRAD or separation will not be delayed to

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accomplish ACAP activities 90 days pre-separation.) ACAP also provides a wide range of valuable transition and job assistance activities and resources that can make a real difference in the rest of your life. If you want your future to be as rewarding as it can be, get to your ACAP center and take advantage of what they have to offer.

c. Soldiers awaiting medical evaluation proceedings are required to start their

ACAP transition activities. They are also encouraged to participate in employment services available at their supporting ACAP center. In addition, Soldiers and their Family members are eligible to continue to use ACAP services for 180 days after REFRAD.

d. Soldiers who reach optimal therapeutic benefit (OTB), but do not meet

medical retention standards IAW AR 40-501, should immediately start the ACAP process.

e. CareerOneStop (www.careeronestop.org) is an integrated suite of national

web sites that help businesses, job seekers, students, and workforce professionals find employment and career resources. To find a local office, go to “Service Locator” and enter your zip code or city/state location. CareerOneStop, sponsored by the U.S. Department of Labor, includes three core products:

(1) America's Career InfoNet (www.CareerInfoNet.org) provides national,

state and local career information and labor market data using unique career tools, career reports, videos, a career resource library and other innovative web-based tools.

(2) America's Job Bank (www.ajb.org) is the nation's largest online labor

exchange. Businesses post job listings, create customized job orders, and search resumes. Job seekers post resumes and search for jobs that fit their career goals. A companion web site, Department of Defense Job Search (http://dod.jobsearch.org), is a career resource for businesses and military personnel transitioning to civilian careers to match work opportunities.

(3) America's Service Locator (www.ServiceLocator.org) maps customers

to a range of local services including workforce centers, unemployment benefits, job training, education opportunities, and other workforce services.

7-4. RECOVERY EMPLOYMENT ASSISTANCE LIFELINE (REALifeline)

a. The Recovery Employment Assistance Lifelines (REALifeline) program, which provides individualized job training, counseling, and employment services to seriously injured and wounded veterans and their families, is a national program coordinated by the Department of Labor’s Veterans’ Employment and Training Service (VETS).

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b. REALifeline supports the economic recovery and civilian employment of these transitioning service members and their families by identifying barriers to employment or reemployment before separation from active military service. These employment needs are then addressed with the help of a disabled veterans outreach program specialist and local veterans employment representatives at the Department of Labor’s nationwide network of One Stop Career Centers. Follow-up professional and personalized intervention for service members and their families during recovery and rehabilitation assures success.

c. In addition to assisting injured and wounded veterans, job training and

employment services are also available to spouses in families that have suffered an active-duty casualty, as well as to Family members who have temporarily left their jobs to be with their loved ones during recovery.

d. REALifeline is fully integrated with the Defense Department’s Military

Severely Injured Center and works closely with the President’s National Hire Veterans Committee to better connect service members to employers.

e. For more information contact: The REALifeline Career Coach at 253-967-

5589, the Labor Department’s VETS at 360-438-4035/4600, and the military Severely Injured Center at 1-888-774-1361.

MEDICAL HOLDOVER PROGRAM MISSION STATEMENT “The Department of The Army conducts Medical Holdover (MHO) operations to expeditiously and effectively evaluate, treat, return to duty, and/or administratively process out of The Army and refer to the Veterans Health Administration or TRICARE health system, RC Soldiers who have suffered injury or illness while mobilized.” The WT or MHO Team, which includes the WTU/MRPU Commander, platoon sergeant, primary care manager, nurse case manager, specialty medical providers, and support personnel, facilitates the return of Soldiers to the fighting strength. The WT mission encompasses three phases:

1. Intake and reception 2. Treatment, healing and evaluation 3. Transition

The WT/MHO mission accomplishes the following:

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a. Provide Command and control (C2), administrative, and operational support for US Army Reserve and National Guard Soldiers in WT/Medical Holdover status.

b. Treat all Soldiers with the dignity and respect they deserve.

c. Treat line of duty medical conditions to the point at which it can be

determined that the Soldier meets or will meet Army retention standards for medical fitness in accordance (IAW) AR 40-501.

d. Assist Soldiers with the transition to civilian life with dignity and

compassion.

e. Coordinate the Soldier’s treatment plans, disposition and best options with the WT team, local military medical treatment facility, installation support agencies, and the Community Based Health Care Organizations (CBHCO).

SOLDIER’S CREED

I am an American Soldier. I am a Warrior and a member of a team.

I serve the people of the Unites States and live the Army Values. I will always place the mission first.

I will never accept defeat. I will never quit.

I will never leave a fallen comrade. I am disciplined, physically and mentally tough, trained and proficient in my warrior tasks

and drills. I always maintain my arms, my equipment and myself.

I am an expert and I am a professional. I stand ready to deploy, engage, and destroy the enemies of the United States of

America in close combat.

I am a guardian of freedom and the American way of life. I am an American Soldier.

ARMY VALUES

Loyalty Loyalty is the faithful adherence to a person, unit, or Army. The thread binds our actions

together and causes us to support each other, our superiors, our Family, and our country.

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Duty Duty is the legal or moral obligation to accomplish all assigned or implied tasks to the

fullest of your ability. Every Soldier shall do what needs to be done without having to be told to do it.

Respect

Respect is treating others with consideration and honor. It is the ability to accept and value other individuals.

Selfless Service

Selfless service is placing your duty before your personal desires. It is the ability to endure hardships and insurmountable odds because of love of fellow Soldiers and our

country.

Honor Honor is living up to the Army Values. It starts with being honest with one’s self and

being truthful and sincere in all of our actions.

Integrity Integrity means to firmly adhere to a code of moral and ethical principles. Every Soldier

shall possess high personal moral standards and be honest in word and deed.

Personal Courage Physical courage is overcoming fears of bodily harm while performing your duty. Moral courage is overcoming fears of other than bodily harm while doing what is right even if

unpopular.

CREED OF THE NONCOMMISSIONED OFFICER No one is more professional than I. I am a Noncommissioned Officer, a leader of Soldiers. As a Noncommissioned Officer, I realize that I am a member of a time honored corps, which is known as "The Backbone of the Army.” I am proud of the Corps of Noncommissioned Officers and will at all times conduct myself so as to bring credit upon the Corps, the Military Service and my country regardless of the situation in which I find myself. I will not use my grade or position to attain pleasure, profit, or personal safety. Competence is my watchword. My two basic responsibilities will always be uppermost in my mind – accomplishment of my mission and the welfare of my Soldiers. I will strive to remain tactically and technically proficient. I am aware of my role as a Noncommissioned Officer. I will fulfill my responsibilities inherent in that role. All Soldiers are entitled to outstanding leadership; I will provide that leadership. I know my Soldiers and I will always place their needs above my own. I will communicate consistently with my Soldiers and never leave them uninformed. I will be fair and impartial when recommending both rewards and punishment. Officers of my unit will have maximum time to accomplish their duties; they will not have to accomplish mine. I will earn their respect and confidence as well as that of my Soldiers. I will be loyal to those with whom I serve; seniors, peers, and subordinates alike. I will exercise initiative by taking appropriate action in the absence of orders. I will

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not compromise my integrity, nor my moral courage. I will not forget, nor will I allow my comrades to forget that we are professionals, Noncommissioned Officers, LEADERS!

OFFICER'S CREED I will give to the selfless performance of my duty and my mission the best that effort, thought, and dedication can provide. To this end, I will not only seek continually to improve my knowledge and practice of my profession, but also I will exercise the authority entrusted to me by the President and the Congress with fairness, justice, patience, and restraint, respecting the dignity and human rights of others and devoting myself to the welfare of those placed under my Command. In justifying and fulfilling the trust placed in me. I will conduct my private life as well as my public service so as to be free both from impropriety and the appearance of impropriety, acting with candor and integrity to earn the unquestioning trust of my fellow Soldiers – juniors, seniors, and associates – and employing my rank and position not to serve myself but to serve my country and my unit. By practicing physical and moral courage, I will endeavor to inspire these qualities in others by my example. In all my actions, I will put loyalty to the highest moral principles and the United States of America above loyalty to organizations, persons, and my personal interest.

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APPENDIX A: REQUIRED & RELATED PUBLICATIONS

Army Regulation (AR) 40-3, Medical, Dental and Veterinary Care, dated 3 Apr 06 AR 40-66, Medical Record Administration and Health Care Documentation, dated 21 Jun

06 AR 40-68, Clinical Quality Management, dated 26 Feb 04 AR 40-400, Patient Administration, dated 12 Mar 01 AR 40-501, Standards of Medical Fitness, dated 27 Jun 06 AR 135-381, Incapacitation of Reserve Component Soldiers, dated 29 Aug 05 AR 600-8-1, Army Casualty Program, dated 7 Apr 06 AR 600-8-4, Line of Duty Policy, Procedures, and Investigations, dated 15 Apr 04 AR 600-8-10, Leaves and Passes, dated 15 Feb 06 AR 600-8-22, Military Awards, dated 11 Dec 06 AR 600-8-101, Personnel Processing (In-, Out-, Soldier Readiness, Mobilization and Deployment Processing), dated 18 Jul 03 AR 600-9, The Army Weight Control Program, dated 27 Nov 06 AR 600-20, Army Command Policy, dated 7 Jun 06 AR 600-60, Physical Performance Evaluation System, dated 25 Jun 02 AR 600-85, Army Substance Abuse Program (ASAP), dated 24 Mar 06 AR 623-3, Evaluation Reporting System, dated 15 May 06 AR 635-40, Physical Evaluation for Retention, Retirement, or Separation, dated 8 Feb

06 AR 670-1, Wear and Appearance of Army Uniforms and Insignia, dated 3 Feb 05 Department of Army (DA) Personnel Policy Guidance for Contingency Operations in

Support of GWOT, 3 Jan 07 DA Medical Holdover (MHO) Consolidated Guidance, 11 Oct 06

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Department of Army Pamphlet (DA Pam) 611-21, Military Occupational Classification

and Structure, dated 3 Mar 99 DA Pam 623-3, Evaluation Reporting System, dated 15 May 06 Department of Veterans Affairs Schedule for Rating Disabilities (VASRD) Department of Defense Directive (DoDD) 1241.1, Reserve Component Medical Care and Incapacitation Pay for Line of Duty Conditions, dated 28 Feb 04. DoDD 1332.18, Separation or Retirement for Physical Disability, dated 04 Nov 06 DoDD 1332.35, Transition Assistance for Military Personnel, dated 09 Dec 93 Department of Defense Instructions (DoDI) 1332.38, Physical Disability Evaluation, dated 14 Nov 96 DoDI 1332.39, Application of the Veterans Administration Schedule for Rating Disabilities, dated 14 Nov 96

FORSCOM Implementation Plan for Community Based Health Care Initiative (CBHCI) Department of Defense Financial Management Regulation (DoDFMR) 7000.14-R, Volume 7A, Military Pay Policy and Procedures – Active Duty and Reserve Pay, Dec 2006. DoDFMR 7000.14-R, Volume 9, Travel Policies and Procedures, Jan 2007. Headquarters, Department of the Army (HQDA), Operations Order (OPORD) 04-01, Annex Q (Medical Holdover Operations), 201136JAN04 Joint Federal Travel Regulation, Vol. 1, dated 1 Dec 04, change 216 Title10 United States Code, Section 61 (10 USC 61), Retirement or Separation for Physical Disability

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APPENDIX B: REQUIRED & RELATED FORMS

DA Form 199, Physical Evaluation Board Proceedings DA Form 199-1, Election to Formal Physical Evaluation Board Proceedings DA Form 2173, Statement of Medical Examination and Duty Status (often referred to as

Line of Duty (LOD)) DA Form 3349, Physical Profile DA Form 3947, Medical Evaluation Board Proceedings DA Form 4187, Personnel Action DD Form 214, Certificate of Release or Discharge from Active Duty DD Form 261, Report of Investigation – Line of Duty and Misconduct Status DD Form 689, Individual Sick Slip DD Form 1610, Request and Authorization for TDY Travel of DoD Personnel OTSG/MEDCOM CBHCO Referral Form VA Form 21-526, Veterans Application for Compensation or Pension (Available at http://www.va.gov/vaforms/)

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APPENDIX C: SAMPLE WELCOME LETTER Fellow Soldier, Welcome to Fort Gordon. On behalf of our cadre, I want to personally thank you for the sacrifices you have made in support of the Global War on Terrorism. You are a true patriot for answering our Nation’s call. Your assignment to this unit means that you have been injured or wounded and need medical attention. I do believe that you could be in no better place for treatment. The unit cadre and support staff are committed to providing you with outstanding leadership, administrative support, and medical care. You will develop relationships with your clinical case manager, platoon sergeant, the administrative support staff, and various installation support agencies as you begin your plan of care. Throughout this process the expectation is that you will be treated with dignity and respect at all levels. I want to know if you experience anything less. Your road map to success:

1. Know this handbook. The answers to most of your questions are contained in this handbook.

2. Remain drug free. We have experienced NCOs running our drug-

testing program and 100 percent testing is in effect. If you have a substance abuse problem and desire help, please inform your chain-of-Command to receive professional help without retribution.

3. Attend all of your appointments. The only way for you to improve

your health is to follow all medical instructions, including attending all appointments.

4. Use your chain-of-Command. The best way to resolve problems is

to develop a good working relationship with your leaders. Again, welcome to Fort Gordon. Although I hope your stay here is short, I am committed to ensuring that you receive optimal, quality care and a smooth transition from active duty to the next step in your journey. John Sample MAJ, MSC Commander

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APPENDIX D: SAMPLE INDIVIDUAL REFERENCE SHEET My CDR is ____________________________ Phone: ________________________ My 1SG is ____________________________ Phone: ________________________ My PSG is _____________________ -______ Phone: ________________________ My Primary Care Provider is ______________ Phone: ________________________ My Case Manager is _____________ _______ Phone: ________________________ My PEBLO is __________________________ Phone: _______________________ My billets are in Building _________________ Room ________________________ My DFAC is in Building ________________________________________________ My duty location is ____________________________________________________ I am currently on ____________orders. They will expire on ___________________. I will contact my platoon sergeant 60 days prior to the expiration of my MRP orders. The company is ___________________ located at ___________________________. They will address issues regarding orders, finance, in- and out- processing, WTU rules, and criteria for participating in the Community Based Health Care Organization. It was determined that I am / am not eligible for CBHCO. I understand that Soldier participation in CBHCO is the Army’s decision. I understand that my primary duty is to recover from my injury/illness and to comply with my medical treatment plan. I will not intentionally delay my disposition nor violate my treatment plan. I have read and understand the Army MHO/WT and WTU company policies and SOPs. I received, read and understand the Warrior in Transition Program MHO Soldier Handbook. I understand that my chain-of-Command is my first step in resolving issues or concerns. ______________________________________________________________________ (Date) (Soldier – Print and Sign Name) ______________________________________________________________________ (Date) (PSG – Print and Sign Name)

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APPENDIX E: SAMPLE IMPORTANT NUMBERS Commander _________________________________________ Office: XXX-XXX-XXXX ____________________________________________________ Cell: XXX-XXX-XXXX

First Sergeant _________________________ ______________ Office: XXX-XXX-XXXX ____________________________________________________ Cell: XXX-XXX-XXXX Executive Officer _____________________________________ Office: XXX-XXX-XXXX ____________________________________________________ Cell: XXX-XXX-XXXX 1st Platoon___________________________________________ Office: XXX-XXX-XXXX ____________________________________________________ Cell: XXX-XXX-XXXX 2nd Platoon __________________________________________ Office: XXX-XXX-XXXX ____________________________________________________ Cell: XXX-XXX-XXXX 3rd Platoon___________________________________________ Office: XXX-XXX-XXXX ____________________________________________________ Cell: XXX-XXX-XXXX 4th Platoon___________________________________________ Office: XXX-XXX-XXXX ____________________________________________________ Cell: XXX-XXX-XXXX S3 _________________________________________________ Office: XXX-XXX-XXXX ____________________________________________________ Cell: XXX-XXX-XXXX Supply Tech _________________________________________ Office: XXX-XXX-XXXX ____________________________________________________ Cell: XXX-XXX-XXXX Mail Room___________________________________________ Office: XXX-XXX-XXXX

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Chaplain ____________________________________________ Office: XXX-XXX-XXXX ____________________________________________________ Cell: XXX-XXX-XXXX Human Resources ____________________________________ Office: XXX-XXX-XXXX Finance/Pay Inquiries _________________________________ Office: XXX-XXX-XXXX Clinical Case Manager_________________________________ Office: XXX-XXX-XXXX ____________________________________________________ Cell: XXX-XXX-XXXX CQ / Duty Driver Office ________________________________ Office: XXX-XXX-XXXX ____________________________________________________ Cell: XXX-XXX-XXXX

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APPENDIX F: SAMPLE OTHER SERVICES CONTACT LIST American Red Cross...............................................................................XXX-XXX-XXXX Army Career and Alumni Program (ACAP)...........................................XXX-XXX-XXXX Army Community Services (ACS) ........................................................XXX-XXX-XXXX Army Emergency Relief (AER) ..............................................................XXX-XXX-XXXX Army Substance Abuse Program (ASAP) ...........................................XXX-XXX_XXXX Army Wounded Warrior Program (AW2) ...............................................1-800-237-1336 Department of Veterans Affairs (DVA or VA).........................................1-800-827-1000 ....................................................................................................................... www.va.gov Regional or Local ....................................................................................XXX-XXX-XXXX Department of Labor (DOL) ...................................................................XXX-XXX-XXXX Dental Treatment Facility .......................................................................XXX-XXX-XXXX Finance – Pay Inquiries ARNG....................................... 1-877-ARNGPAY or 317-510-3243 or DSN 699-3243 USAR....................................................................................................1-877-462-7782 Fisher House ...........................................................................................XXX-XXX-XXXX Fitness Center(s) ....................................................................................XXX-XXX-XXXX Medical Treatment Facility .....................................................................XXX-XXX-XXXX Military One Source .................................................................................1-800-342-9647 Military Severely Injured Center ............................................................XXX-XXX-XXXX Vet Center ................................................................................................XXX-XXX-XXXX Wounded Soldier Family Hotline……………………………………………1-800-984-8523

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APPENDIX G: SAMPLE SOLDIER’S APPOINTMENT SCHEDULE

DATE TIME CLINIC PROVIDER

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

.___________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

____________________________________________________________________

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APPENDIX H: GLOSSARY ACAP – Army Career and Alumni Program AC – Active Component ACS – Army Community Services ACU – Army Combat Uniform AD – Active Duty AHLTA – Armed Forces Health Longitudinal Technology Application; the Army’s electronic medical record ANG – Air National Guard AR – Army Regulation ARNG – Army National Guard ASAP – Army Substance Abuse Program AWOL – Absent Without Leave BAH – Basic Allowance for Housing BAMC – Brooke Army Medical Center BAS – Basic Allowance for Subsistence C2 – Command and Control C3 – Command, Control and Communication CBHCO – Community Based Health Care Organization CM – Nurse Case Manager (clinical) CIP – Combat Related Injury Rehabilitation Pay CRSA – Combat-Related Special Compensation CSA – Chief of Staff, US Army DA – Department of the Army DCCS – Deputy Chief for Clinical Services (chief physician)

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DCU – Desert Combat Uniform DFAC – Dining Facility DFAS – Defense Finance and Accounting System DoD – Department of Defense DoDD – Department of Defense Directive DoDI – Department of Defense Instruction DVA – Department of Veterans Affairs, also see VA EAMC – Eisenhower Army Medical Center; also DDEAMC EO – Equal Opportunity EPTS – Existed Prior to Service ESGR – Employer Support of the Guard and Reserve FINCOM – US Army Finance Command FORSCOM – US Army Forces Command FSA – Family Separation Allowance FTUS – Full Time Unit Support GPRMC – Great Plains Regional Medical Command HIPAA – Health Insurance Portability and Accountability Act HRC-A – Human Resources Command – Alexandria HRC-STL – Human Resources Command – St. Louis HREC – Health Records IMCOM – US Army Installation Management Command INCAP Pay – Incapacitation Pay IPFU – Improved Physical Fitness Uniform JAG – Judge Adjutant General JFHQ – [state] – Joint Forces Headquarters for [state] US Army and Air National Guard JFTR – Joint Federal Travel Regulation

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LOD – Line of Duty LODI – Line of Duty Investigation MAMC – Madigan Army Medical Center MCSS – Military Clothing Sales Store MEB – Medical Evaluation Board MEDCOM – US Army Medical Command MEDEVAC – Medical Evacuation; also Medical Aero-evacuation MEDHOLD or MHU or MHC – Medical Holding Unit or Company (MTF unit) MHO – Medical Holdover (mobilized RC Soldiers) MMRB – Medical/MOS Retention Board MO – Medical Officer MODS – Medical Operational Data System (formerly Medical Occupational Data System) MRP – Medical Retention Processing MRP2 – Medical Retention Processing 2, recalls Soldiers already REFRAD MRPU – Medical Retention Processing Unit MTF – Medical Treatment Facility MWR – Morale, Welfare & Recreation NARMC – North Atlantic Regional Medical Command NARSUM – Narrative Summary (Part of MEB) NDAA – National Defense Authorization Act NGB – National Guard Bureau NCOER – Noncommissioned Officer Evaluation Report NCOES – Noncommissioned Officer Education System OASA (M&RA) – Office of the Assistant Secretary of the Army for Manpower and

Reserve Affairs

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OASD (HA) – Office of the Assistant Secretary of Defense for Health Affairs OCAR – Office of the Chief, Army Reserve OER – Commissioned Officer Evaluation Report OMPF – Official Military Personnel File OTB – Optimal Therapeutic Benefit OTJAG – Office of the Judge Adjutant General OTSG – Office of the Surgeon General PAD – Patient Administration Division PCM – Primary Care Manager PDES – Physical Disability Evaluation System PDRL - Permanent Disability Retired List PEB – Physical Evaluation Board PEBLO – Physical Evaluation Board Liaison Officer PHI – Protected Health Information PPG – Personnel Policy Guidance PSG – Platoon Sergeant PT – Physical Therapy (medical treatment plan) PT – Physical Training (C2 physical performance plan) RC – Reserve Component REFRAD - Release from Active Duty SDNCO – Staff Duty NCO SERMC – Southeast Regional Medical Command SMA – Sergeant Major of the US Army SRC – Soldier Readiness Center SRP – Soldier Readiness Processing

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TAG – The Adjutant General (US Army) TAMC – Tripler Army Medical Center TAMP – Transitional Assistance Management Program, 180 days of TRICARE benefits

for Soldier and Family members following REFRAD from mobilization orders TC – Transition Center TCS – Temporary Change of Station; for RC, generally the same as PCS for AC TDRL – Temporary Disability Retired List TF – Task Force Title 10 USC §12301(d) – Statutory authority for MRP and MRP2 Title 10 USC §12302 – Statutory authority for partial mobilization Title 10 USC §12304 – Statutory authority for Presidential Select Reserve Call-up

(PSRC), PSRC is not a mobilization

Title 10 USC §12301(h) – Statutory authority for Active Duty Medical Extension (ADME)

TMA – TRICARE Management Agency TRICARE – DoD health care program TRS – TRICARE Reserve Select TJAG – The Judge Adjutant General (US Army) TSG – The Surgeon General (US Army) TSGLI – Traumatic Service members Group Life Insurance UCMJ – Uniform Code of Military Justice USAF – US Air Force USAMEDCOM – US Army Medical Command U.S.C. – United States Code USAPDA – US Army Physical Disability Agency USAR – US Army Reserve USERRA – Uniformed Services Employment and Re-employment Rights Act

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USN – US Navy VA – Formerly Veterans Administration, generic term for DVA, VHA, VBA, Vet Centers,

or other organizational elements of the DVA

VBA – Veterans Benefits Administration (non-medical benefits) VHA – Veterans Health Administration (medical benefits) VASRD – Veterans Administration Schedule for Rating Disabilities WRMC – Western Regional Medical Center WRAMC – Walter Reed Army Medical Center WT – Warrior in Transition WTU – Warrior in Transition Unit

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SECTION D-3 WARRIOR IN

TRANSITION (WT) – MISCELENEOUS

SUPPORTING DOCUMENTS

Revised 8 August 2007

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D-1 ASA (M&RA) DOCUMENTS: PAGE: D-1-1 MRP Implementation Memorandum, dated 6 March 2004 277 D-1-2 MRP2 Implementation Memorandum, dated 17 April 2006 279 D-1-3 Authority to implement 12301(h): JAG interpretation 281 D-2 HQDA, DCS, G-1 DOCUMENTS: PAGE: D-2-1 ALARACT Message 193/2006, COTTADS in Support of the GWOT 285 D-2-2 Appeal and Exceptions process flowcharts 286 D-2-3 ALARACT 0607: Applicable processing procedures for military orders 288 D-2-4 MILPER: 07-075 Applicable processing procedures for military orders pertaining to soldiers in a patient status who are moved from the theater (OEF and OIF) to a CONUS military treatment facility (MTF) 292 D-2-5 MILPER MSG: 05-273 LOD post deployment health reassessment policy 300 D-2-6 MILPER: 07-179 WTU cadre personnel (assignment and stabilization of active component soldiers) 303 D-2-7 ALARACT 134/2006: combat-related injury rehabilitation pay (CIP) policy 304 D-2-8 ALARACT 147/2006: announcement of the medical holdover (MHO) consolidated guidance 311 D-2-9 MILPER: 07-206 AHRC-PED DD form 93 update: non-medical attendant 314 D-3 OTHER MISCELLENEOUS DOCUMENTS: PAGE: D-3-1 Request for REFRAD -with Transition Leave (AHRC form) 316 D-3-2 Request for early REFRAD (AHRC form) 317

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D-1-1 MRP Implementation Memorandum, dated 6 March 2004

71

72

D-1-2 MRP2 Implementation Memorandum, dated 17 April 2006

73

74

D-1-3 Authority to implement 12301(h): JAG interpretation

75

76

77

78

D-2 HQDA, G1, DCS, G-1 DOCUMENTS D-2-1 ALARACT Msg 193/2006: COTTADS in support of the GWOT

79

80

D-2-2 Appeal and Exceptions process flowcharts

Soldier moves to appeal rejection of

packet

Soldier writes letter requesting

appeal of rejection

Soldier’s unit commander

attaches cover-letter and forwards

up the chain of command

Soldier’s component?

Army National Guard

Army Reserve

Forward appeal request through RRC with cover

letter

Forward appeal request through State NG with

cover letter

Forward appeal through National Guard Bureau

Type of appeal

Administrative

Medical

Forward appeal for Review by

HQDA, G1 DAPE-MPE-DR

Forward to: OTSG, MHO Physician

Consultant

Appeal Approved?

No

Yes

Soldier and unit informed; Soldier may

Appeal to ABCMR

Packet will be referred to HRC-A for processing and

forward to the MRB

Appeal Approved?

No Soldier and unit informed; Soldier may

Appeal to ABCMR

Yes

Forward to HRC-A for processing

Orders are published Soldier and unit notified

WTU Appeal Process

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D-2-3. ALARACT 06/07: APPLICABLE PROCESSING PROCEDURES FOR MILITARY ORDERS SUBJECT: TRANSITION LEAVE PROCESSING FOR ACTIVE COMPONENT (AC) AND RESERVE COMPONENT (RC) WARRIORS IN TRANSITION AND OTHER SOLDIERS TRANSITIONING FROM ACTIVE DUTY IN CONNECTION WITH A PHYSICAL DISABILITY EVALUATION 1. REFERENCES: A. ARMY HUMAN RESOURCES COMMAND MILPER MESSAGE 05-036, IS RESCINDED. B. DEPARTMENT OF DEFENSE DIRECTIVE 1327.6, DOD POLICY ON LEAVE AND LIBERTY PROCEDURES. C. DOD INSTRUCTION 1332.38, PHYSICAL DISABILITY EVALUATION. D. DEPARTMENT OF THE ARMY PERSONNEL POLICY GUIDANCE (PPG) FOR CONTINGENCY OPERATIONS IN SUPPORT OF GWOT. E. DEPARTMENT OF THE ARMY MEDICAL HOLDOVER (MHO) CONSOLIDATED GUIDANCE. F. AR 600-8-10, LEAVES AND PASSES. G. AR 635-40, PHYSICAL EVALUATION FOR RETENTION, RETIREMENT, OR SEPARATION. 2. EXPIRATION: THIS MESSAGE EXPIRES 30 MAY 2009. 3. PURPOSE: THIS MESSAGE REVISES EXISTING POLICIES AND PROCEDURES FOR AC AND RC WARRIORS IN TRANSITION AND OTHER SOLDIERS TRANSITIONING FROM ACTIVE DUTY WHO HAVE COMPLETED THE PHYSICAL DISABILITY EVALUATION SYSTEM (PDES) AND AUTHORIZES THEM TO TAKE TRANSITION LEAVE (FORMERLY CALLED TERMINAL LEAVE). IT ALSO ESTABLISHES A 90 DAY SEPARATION WINDOW FOR ALL MEDICAL DISABILITY, SEPARATION AND RETIREMENT CASES. 4. APPLICABILITY: THIS MESSAGE APPLIES TO ALL WARRIORS IN TRANSITION TO INCLUDE THOSE REQUESTING TRANSFER TO THE RETIRED RESERVE, AS A RESULT OF BEING FOUND UNFIT DUE TO PHYSICAL DISABILITY. IT ALSO APPLIES TO RC SOLDIERS TRANSITIONING FROM ACTIVE DUTY MEDICAL EXTENSION STATUS BACK TO THEIR RC UNIT UPON COMPLETION OF MEDICAL CARE.

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5. WHEN A SOLDIER IS FOUND “UNFIT” BY THE PHYSICAL EVALUATION BOARD (PEB) AND ALL APPEALS AND REVIEWS REQUIRED BY AR 635-40 ARE COMPLETED, THE U.S. ARMY PHYSICAL DISABILITY AGENCY (USAPDA), U.S. ARMY HUMAN RESOURCE COMMAND (AHRC) WILL TRANSMIT VIA TRANSPOC-III OR VIA MESSAGE TO THOSE INSTALLATIONS WITHOUT TRANSPOC, THE REQUIRED DATA TO COMPLETE THE ORDERS PROCESS. ONCE RECEIVED, THE INSTALLATIONS TRANSITION CENTER OR OTHER PERSONNEL SUPPORT FACILITY WILL PUBLISH THE DISCHARGE, REFRAD, OR RETIREMENT ORDER IN A TIMELY MANNER. THE USAPDA WILL ASSIGN A “NOT LATER THAN” SEPARATION DATE THAT WILL NOT EXCEED 90-DAYS AFTER THE COMPLETION OF PROCESSING BY USAPDA. THE INSTALLATION COMMANDER, THROUGH THE TRANSITION CENTER, WILL ESTABLISH A SEPARATION DATE WITHIN THE 90-DAY WINDOW. THE NOT TO EXCEED 90-DAY WINDOW ALLOWS INSTALLATIONS FLEXIBILITY TO ASSIGN A SEPARATION DATE WITHIN THE 90-DAY WINDOW BASED ON INDIVIDUAL SOLDIER CIRCUMSTANCES BUT SHOULD NOT BE CONSTRUED AS AN OPPORTUNITY TO DELAY DEPARTURE OF A SOLDIER FROM ACTIVE DUTY. GENERALLY, THE SEPARATION DATE SHOULD FACTOR IN THE NUMER OF DAYS REQUIRED TO CLEAR THE COMMAND, AUTHORIZE PERMISSIVE TEMPORARY DUTY (PTDY) (TO ELIGIBLE AC SOLDIERS) AND USE OF ACCRUED LEAVE (TRANSITION LEAVE). 6. ANNUAL LEAVE: ALL AC AND RC SOLDIERS ARE REMINDED AND ENCOURAGED TO TAKE LEAVE DURING THE PERIOD OF ACTIVE DUTY, TO INCLUDE PERIODS OF ACTIVE DUTY WHILE PROCESSING THROUGH THE WARRIOR TRANSITION UNIT (WTU) AND THE PDES PROVIDED THAT SUCH LEAVE DOES NOT CONFLICT WITH COMPLETION OF MEDICAL PROCESSING OR THE MEDICAL EVALUATION BOARD AS PRESCRIBED BY AR 635-40, PARAGRAPH E-4A. LEAVE MUST BE COORDINATED WITH THE CHAIN OF COMMAND AND MTF PHYSICAL EVALUATION BOARD LIAISON OFFICER (PEBLO). WARRIORS IN TRANSITION ARE AUTHORIZED TRANSITION LEAVE (FORMERLY CALLED TERMINAL LEAVE) AFTER COMPLETING MEDICAL PROCESSING OR THE PDES PROCESS AND PRIOR TO DISCHARGE, REFRAD, SEPARATION OR RETIREMENT. APPROVAL AUTHORITY IS THE FIRST COLONEL IN THE MTF/WTU CHAIN OF COMMAND. 7. POINT OF CONTACTS: (1) HQDA, DCS, G-1, COMPENSATION & ENTITLEMENTS DIVISION POLICY PROPONENT IS LTC VOITHOFER, DSN 222-6889 OR COMMERCIAL (703) 692-6889; EMAIL MATTHEW.VOITHOFER@HQDA.ARMY.MIL OR MR. BOSKO, DSN 222-5945 OR COMMERCIAL (703) 692-5945, OR VICTOR.BOSKO@HQDA.ARMY.MIL.

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(2) AHRC, PERSONNEL SERVICES SUPPORT DIVISION, FUNCTIONAL PROPONENT FOR LEAVES AND PASSES (AR 600-8-10) AND MILITARY ORDER (AR 600-8-105) IS MRS. MCCLELLAND, DSN 221-9005 OR COMMERCIAL (703) 325-9005; EMAIL BRENDA.MCCLELLAND@CONUS.ARMY.MIL. (3) AHRC, PHYSICAL DISABILITY AGENCY FUNCTIONAL PROPONENT FOR PHYSICAL EVALUATION FOR RETENTION, RETIREMENT, OR SEPARATION (AR 635-40) IS MS. DENNIS, DSN: 662-3064 OR (202) 782-3064; EMAIL FRANCES.DENNIS@US.ARMY.MIL. (4) HQDA, DCS, G-1, MEDICAL POLICY IS LTC BAUER, DSN 225-7874 OR COMMERCIAL (703) 695-7874; EMAIL ANNE.BAUER@HQDA.ARMY.MIL AND MSG CARMEL, HQDA, DCS, G-1, DSN 225-7864 OR COMMERCIAL (703) 695-7864; EMAIL MICHAEL.CARMEL@HQDA.ARMY.MIL.

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D-2-4 MILPER MESSAGE: 07-075

AHRC-PDO-IP APPLICABLE PROCESSING PROCEDURES FOR MILITARY ORDERS

PERTAINING TO SOLDIERS IN A PATIENT STATUS WHO ARE MOVED FROM THE THEATER (OPERATION ENDURING FREEDOM (OEF) AND

OPERATION IRAQI FREEDOM (OIF)) TO A CONUS MILITARY TREATMENT FACILITY (MTF)

...Issued: [03/30/2007]...

A. JOINT FEDERAL TRAVEL REGULATION, PARAGRAPH U5630. B. DEPARTMENT OF DEFENSE INSTRUCTION 6000.11. C. DEPARTMENT OF DEFENSE DIRECTIVE 6000.12. D. DEPARTMENT OF THE ARMY PERSONNEL POLICY GUIDANCE (PPG). E. DEPARTMENT OF THE ARMY MEDICAL HOLDOVER (MHO) CONSOLIDATED GUIDANCE. F. AR 600-8-105, MILITARY ORDERS. G. AR 614-6, PERMANENT CHANGE OF STATION POLICY. H. AR 614-200, ENLISTED ASSIGNMENT AND UTILIZATION MANAGEMENT . I. AR 614-30, CHAPTER, 2, OVERSEAS SERVICE. J. AR 40-400, PATIENT ADMINISTRATION K. AR 135-381, INCAPACITATION OF RESERVE COMPONENT SOLDIERS. L. AR 600-8-4, LINE OF DUTY POLICY, PROCEDURES AND INVESTIGATIONS. M. AR 600-8-10, LEAVES AND PASSES. N. AR 600-60, PHYSICAL PERFORMANCE EVALUATION SYSTEM. O. AR 614-100, OFFICER ASSIGNMENT POLICIES, DETAILS, AND TRANSFERS. 1. EXPIRATION: THIS MESSAGE EXPIRES 31 MARCH 2009. 2. PURPOSE: THIS MESSAGE CLARIFIES AND PROVIDES POLICY GUIDANCE PERTAINING TO SOLDIERS WHO WERE INJURED OR BECAME ILL OR

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AGGRAVATE PREEXISTING CONDITIONS WHILE ON ACTIVE DUTY (AD) WHILE IN SUPPORT OF A CONTINGENCY OPERATION (GWOT) AND MUST BE TRANSFERRED TO A CONUS BASED MTF AND WILL LIKELY BE TRANSFERRED TO A WARRIOR TRANSTION UNIT (WTU). 3. LINE OF DUTY INVESTIGATIONS (LODI) FOR RESERVE COMPONENT (RC) SOLDIERS: COMMANDERS MUST ENSURE A LODI IS COMPLETED ON EVERY SOLDIER PRIOR TO MEDEVAC. THE LODI SERVES AS PERMANENT DOCUMENTATION OF THE MEDICAL EVENT AND CIRCUMSTANCES AND WILL ENSURE EVERY SOLDIER'S ABILITY TO RECEIVE APPROPRIATE FOLLOW-ON TREATMENT, RECEIVE APPROPRIATE CONSIDERATION FOR ENTITLEMENTS THROUGH THE PHYSICAL DISABILITY EVALUATION SYSTEM (PDES) AND INCAPACITATION PAY PROGRAM, AND APPLY FOR BENEFITS THROUGH THE DEPARTMENT OF VETERANS AFFAIRS. HOWEVER, IF THE LODI IS NOT COMPLETED BY THE SOLDIER’S COMMANDER PRIOR TO THE SOLDIER ENTERING THE WTU (MHO) PROGRAM, THEN IT IS THE RESPONSIBILITY OF THE CURRENT UNIT COMMANDER, WTU (MRPU) COMMANDER, OR COMMUNITY BASE HEALTH CARE ORGANIZATION (CBHCO) COMMANDER, TO ENSURE THAT A LODI IS COMPLETED AS PRESCRIBED BY AR 600-8-4. 4. ACCOUNTABILITY: SOME SOLDIERS EVACUATED FROM THEATER ARE NOT PROPERLY TRACKED IN THE TRANSCOM REGULATING AND COMMAND & CONTROL EVACUATION SYSTEM (TRAC2ES) SYSTEM FOR ACCOUNTABILITY PURPOSES. THIS SYSTEM TIES TOGETHER PATIENT ACCOUNTABILITY FROM THE FIELD, WHILE IN TRANSIT AND AT DESTINATION. THE JOINT PATIENT TRACKING APPLICATION (JPTA) IN CONJUNCTION WITH TRAC2ES IN US CENTRAL COMMAND (CENTCOM) AREA OF RESPONSIBILITY (AOR) PROVIDES “TOTAL-IN-TRANSIT” VISIBILITY (ITV). ALL ORIGINATING MTF, WARRIOR TRANSITION UNITS (MHU), WTU, AND SOLDIER PROCESSING ACTIVITIES WILL ENTER ALL PATIENT MOVEMENTS INTO TRAC2ES, THEREBY, GENERATING A PATIENT MOVEMENT REQUEST (PMR) IN TRAC2ES ENSURING POSITIVE CONTROL AND ACCOUNTABILITY. RECOMMEND ALL MTFS UTILIZE MS51 DATABASE, A 3-WAY COMPARISON OF E-MILPO, TAPDB AND DJMS TO HAVE VISIBILITY OF THE SOLDIER’S STATUS. 5. TEMPORARY CHANGE OF STATION (TCS) ORDERS: THE PRIMARY PURPOSE OF THE TCS ORDER IS TO SERVE AS A PERSONNEL ACCOUNTABILITY TOOL ABLE TO TRACK PERSONNELAT VARIOUS LOCATIONS BASED ON THE MOVEMENT DESIGNATOR CODE (MDC) PM. THE SECONDARY PURPOSE IS TO AUTHORIZE VARIOUS TRAVEL ENTITLEMENTS; IT PROVIDES THEABILITY TO MOVE A SOLDIER FROM STATION TO STATION AS REQUIRED BY MILITARY NECESSITY. THE FORMAT 401 ORDER IS A LIMITED TCS ORDER, WHICH MAY BE AMENDED, REVOKED, OR RESCINDED BY THE GAINING COMMAND, AS REQUIRED TO

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REFLECT MOVEMENT WITHIN THE (AOR). EMILPO IS USED TO MAINTAIN AND ACCOUNT FOR SOLDIERS ON TCS ORDERS AND ALLOWS THE SUPPORTING UNIT TO UPDATE THE SOLDIER'S PERSONNEL FILE AND FACILITATES ACCOUNTABILITY WITHIN THE PERSONNEL SYSTEM. MOVEMENT TO DUTY LOCATIONS WILL BE ACCOMPLISHED BY THE ORIGINAL TCS ORDER AND ANY AMENDMENT (FORMAT 700) WHEN A VALIDATED REQUIREMENT IS ESTABLISHED AS PRESCRIBED IN THE PERSONNEL POLICY GUIDANCE (PPG) OR WARRIOR TRANSITION UNIT – RC [MEDICAL HOLDOVER (MHO)] CONSOLIDATED GUIDANCE (MHO CG). BOTH ARE FOUND ON THE ARMY G-1 WEB SITE HTTP://WWW.ARMG1.ARMY.MIL ). 6. PERMANENT CHANGE OF STATION (PCS) LIMITATION APPROVAL AUTHORITY: THE ASSISTANT SECRETARY OF THE ARMY MANPOWER AND RESERVE AFFAIRS (ASA (M&RA) IS THEAPPROVAL AUTHORITY FOR MORE THAN TWO PCS MOVES WITHIN THE SAME FY AS PRESCRIBED BY AR 614-6. COMMANDERS OF HOSPITALS HAVING WTU WILL REASSIGN (INTRA) PATIENTS, TO OR BETWEEN MEDICAL HOLDING DETACHMENTS WITHIN THE WTU. IMMEDIATELY UPON TRANSFER, COMMANDERS ARE REQUIRED TO TRANSMIT ALL ASSIGNMENTS TO OR BETWEEN MEDICAL HOLDING DETACHMENT THRU THE WTU COMMANDER TO THE COMMANDER, ARMY HUMAN RESOURCES COMMAND (AHRC), THE SURGEON GENERAL (TSG), THE JUDGE ADVOCATE GENERAL (TJAG) AND CHIEF OF CHAPLAINS (CCH) AS APPROPRIATE. THE MOVEMENT OF A MILITARY MEMBER THAT WOULD CAUSE A SECOND OR SUBSEQUENT PCS IN THE SAME FY IS PROHIBITED; EXCEPT AS AUTHORIZED BY AR 614-6, AR 614-30, AR 614-100 AND AR 614-200. REQUEST FOR SECOND OR SUBSEQUENT CHANGE OF STATION NOT PERMITTED BY THE ABOVE REGULATIONS MUST BE SENT THROUGH COMMAND CHANNELS TO THE ASA (M&RA) BY THE REASSIGNING AUTHORITY. WHEN IT BECOMES APPARENT TO THE ATTENDING MEDICAL AUTHORITIES THAT AN INJURED OR ILL SOLDIER REQUIRES AN EXTENDED TREATMENT AND RECOVERY PLAN, ACTIVE COMPONENT (AC) SOLDIERS ARE OFTEN PCS TO THE HOSPITAL. HOWEVER, UNDER NO CIRCUMSTANCES WILL INJURED/ILL AC SOLDIER PCS TO THE HOSPITAL EARLIER THAN 90 DAYS AFTER THEIR ASSIGNMENT TO THE WTU. THIS WILL GIVE THE FAMILY AND SOLDIER TIME TO CLEAR THE PREVIOUS PERMANENT DUTY STATION (PDS) AND MINIMIZE ANY COMPENSATION ADJUSTMENTS CAUSED BY THE TRANSTION. INSTALLATION COMMANDERS WILL GRANT INJURED/ILL SOLDIERS HIGHEST PRIORITY IN CLEARING QUARTERS (WHEN APPLICABLE), SETTING UP TRANSPORTATION APPOINTMENTS, CLEARING FINANCE, AND ALL RELATED INSTALLATION CLEARING ACTIVITIES. NORMALLY, RC SOLDIERS REQUIRING AN EXTENDED TREATMENT OR RECOVERY PLAN ARE PLACED ON 10 USC 12301(H) ORDERS. REFER TO THE WTU - RC CG. 7. BACK DATING ORDERS: BACK DATING THE REPORT DATE ON PCS

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ORDERS FOR WOUNDED OR ILL SOLDIERS ADMITTED TO MAJOR MEDICAL FACILITIES IS NOT AUTHORIZED. THE PRACTICE OF BACK DATING REPORT DATES ON ORDERS HAS RESULTED IN UNNECESSARY STRESS AND FINANCIAL HARDSHIP TO SOLDIERS AND FAMILY MEMBERS. PCS AND TCS ORDERS MAY ONLY BE CORRECTED BY AMENDMENTS, REVOCATIONS OR RESCISSIONS. COMMANDERS HAVE THE AUTHORITY TO RESCIND ONLY THE UNEXECUTED PORTION OF AN ORDER, IF THE ORDER HAS NOT BEEN EXECUTED IN ITS ENTIRETY BY AN AMENDMENT, REVOCATION OR RESCISSION AS PRESCRIBED BY AR 600-8-105, PARAGRAPH 2-21D. COMMANDERS ARE REMINDED THAT IT IS THEIR RESPONSIBILITY TO ENSURE FULL COMPLIANCE WITH ESTABLISHED PROCEDURES. 8. COUNSELING SOLDIERS, FAMILY MEMBERS OR SOLDIERS REPRESENTATIVE: TO ENSURE SOLDIERS RECEIVE APPROPRIATE PAY AND ENTITLEMENTS DURING ASSIGNMENT/ATTACHMENT TO A MTF, IT IS THE RESPONSIBILITY OF THE MTF TO ENSURE THAT THE SOLDIER OR THE SOLDIER’S REPRESENTATIVE IS PROPERLY COUNSELED AND ADVISED REGARDING PAY AND FINANCIAL OBLIGATIONS THAT MAY OCCUR, TO INCLUDE THE SUSPENSION OF DEBTS. 9. MEDICAL HOLDOVER: THE ASA (M&RA) PROVIDES OVERALL PROGRAM OVERSIGHT FOR WTU - RC PROGRAM OPERATIONS AND IS RESPONSIBLE AS THE OVERALL POLICY PROPONENT FOR WTU - RC OPERATIONS. A WARRIOR IN TRANSITION (WT) SOLDIER IS DEFINED AS A RC SOLDIER MOBILIZED ON 10 UNITED STATES CODE (USC) 12302 ORDERS IN SUPPORT OF CONTINGENCY OPERATIONS AND DIVERTED FROM HIS OR HER NORMAL MOBILIZATION MISSION OR DEMOBILIZATION PROCESSING, OR MEDICALLY EVACUATED (MEDEVAC) FROM THEATER WHO IS IN NEED OF MEDICAL EVALUATION, TREATMENT AND DISPOSITION INCLUDING DEFINITIVE HEALTH CARE FOR MEDICAL CONDITIONS IDENTIFIED, INCURRED OR AGGRAVATED WHILE IN AN AD STATUS IN SUPPORT OF THE GWOT. INITIAL ENTRY OF RC SOLDIER DATA INTO THE MEDICAL OPERATIONAL DATA SYSTEM (MODS) MHO MODULE IS THE TRIGGER THAT ENTERS THE SOLDIER IN THE MHO PROCESS FOR ACCOUNTABILITY AND TRACKING PURPOSES. DISPOSITION OCCURS WHEN THE MHO SOLDIER IS FIT FOR DUTY OR ENTERS THE PDES PROCESS. FOR ADDITIONAL GUIDANCE PLEASE VISIT THE (WTU) CONSOLIDATED GUIDANCE OR THE PERSONNEL POLICY GUIDANCE (PPG). WARRIORS IN TRANSITION SOLDIERS ARE OFTEN ASSIGNED TO THE WTU. THE WTU COMBINES PREVIOUS MEDICAL HOLD COMPANIES (AC SOLDIERS), AND THE MEDICAL HOLDOVER COMPANIES (RC SOLDIERS) INTO ONE ORGANIZATION. THE ARMY IS CURRENTLY TRANSITIONING TO WTU. 10. MEDICAL RETENTION PROCESSING (MRP): THE MRP PROGRAM APPLIES ONLY TO RC SOLDIERS CURRENTLY ON AD FOR CONTINGENCY OPERATIONS IN SUPPORT OF GWOT UNDER PARTIAL MOBILIZATION, 10

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UNITED STATES CODE (USC) 12302 ORDERS AFTER 6 MARCH 2004. MRP SOLDIERS MUST HAVE INCURRED AN ILLNESS, INJURY, OR DISEASE, OR AGGRAVATED A PRE-EXISTING MEDICAL CONDITION IN THE LINE OF DUTY. MOBILIZED RC SOLDIERS WILL REMAIN ON PARTIAL MOBILIZATION ORDERS UNTIL AN APPROPRIATE MEDICAL AUTHORITY DETERMINES THAT THE SOLDIER WILL NOT BE ABLE TO PERFORM MILITARY DUTIES IN THAT STATUS, OR THAT THE SOLDIER WILL NOT HAVE A SUFFICIENT NUMBER OF DAYS LEFT ON AD AFTER THE MEDICAL CONDITION IMPROVES TO PERMIT RETURN TO DUTY (RTD). MILITARY MEDICAL AUTHORITY MUST DETERMINE WHETHER A SOLDIER IS NOT EXPECTED TO RTD WITHIN 60 DAYS FROM THE TIME HE/SHE IS INJURED OR BECOMES ILL OR IF THE SOLDIER COULD RTD WITHIN 60 DAYS, BUT WILL HAVE FEWER THAN 120 DAYS BEYOND THE EXPECTED RTD LEFT ON 10 USC 12302 PARTIAL MOBILIZATION ORDER. IF SO, THEN THE SOLDIER WILL BE CONVERTED FROM PARTIAL MOBILIZATION ORDERS TO MRP 12301(D) ORDERS, SUBJECT TO THE SOLDIER’S CONSENT. FOR SOLDIER ELIGIBILITY FOR THE MHO (MRP AND MRP2 PROGRAMS, PLEASE REFER TO THE ARMY G-1, CONSOLIDATED GUIDANCE AND (HTTP://WWW.ARMYG1.ARMY.MIL ). 11. MEDICAL RETENTION PROCESSING 2 (MRP2) PROGRAM: THE MRP2 PROGRAM APPLIES ONLY TO RC SOLDIERS ALREADY RELEASED FROM ACTIVE DUTY (REFRAD) FROM 10 USC 12302 PARTIAL MOBILIZATION ORDERS. SOLDIERS HAVE SIX MONTHS FROM THEIR DATE OF REFRAD TO APPLY FOR THE MRP2 PROGRAM. THE MRP2 PROGRAM IS DESIGNED TO EVALUATE AND TREAT ILLNESS, INJURY, OR DISEASE THAT THE MRP2 MEDICAL REVIEW BOARD DETERMINES AS THE REASON TO RETURN THE SOLDIER BACK TO AD. MRP2 SOLDIERS VOLUNTARILY TRANSITION ONTO ACTIVE DUTY FOR MEDICAL RETENTION PROCESSING TO INCLUDE PARTICIPATION IN THE CBHCO. 12. U.S ARMY WOUNDED WARRIOR PROGRAM (AW2): ON APRIL 2004, THE DEPARTMENT OF THE ARMY INTRODUCED A DISABLED SOLDIER SUPPORT SYSTEM (DS3), AND ON 10 NOVEMBER 2005 THE NAME OF THE PROGRAM WAS OFFICIALLY CHANGED TO THE U.S. ARMY WOUNDED WARRIOR PROGRAM (AW2). THIS PROGRAM PROVIDES SEVERELY DISABLED SOLDIERS AND THEIR FAMILIES WITH A SYSTEM OF ADVOCACY AND FOLLOW-ON SUPPORT TO ASSIST THEM AS THEY TRANSITION BACK TO MILITARY SERVICE OR INTO THE CIVILIAN COMMUNITY. 13. SOLDIERS OR REPRESENTATIVES: SOLDIERS ENTERING INTO WTU ARE REMINDED TO UPDATE ANY CHANGES IN THEIR FAMILY RECORD AND ADDRESS IN THE DEFENSE ELIGIBILITY REPORTING SYSTEM (DEERS). FAILURE TO KEEP THIS INFORMATION CURRENT MAY RESULT IN FUTURE DENIAL OF HEALTH CARE BENEFITS AND ENTITLEMENTS SUCH AS OFFICE VISITS, SPECIALTY CARE, AND PHARMACY SERVICES INCLUDING MEDICATION REFILLS AS WELL AS DENIAL OF PENDING CLAIMS.

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14. LEAVES AND PASSES: THE WTU COMMANDER IS ENCOURAGED TO GRANT LEAVE AS PRESCRIBED BY AR 600-8-10 AS LONG AS AUTHORIZED LEAVE DOES NOT INTERFERE WITH OR EXTEND THE SOLDIER’S MEDICAL CARE, MEDICAL RETENTION AND EVALUATION PROCESS, OR DELAY OUT-PROCESSING FROM THE MRP PROGRAM. PERMISSIVE TEMPORARY DUY IS NOT AUTHORIZED. TRANSITION LEAVE MAY BE AUTHORIZED FOR BOTH AC AND RC SOLDIERS AS THEY ARE SEPARATING FROM THE ARMY. EXCEPTION APPROVAL AUTHORITY IS THE FIRST COLONEL COMMANDER IN THE HOSPITAL/WTU CHAIN OF COMMAND. MORE SPECIFIC GUIDANCE IS FOUND IN THE SEPARATE TRANSITION LEAVE MILPER MESSAGE.

15. RENTAL CARS. SOLDIERS WITHIN THE WTU MAY BE AUTHORIZED A RENTAL CAR DURING THEIR TRANSITION PERIOND WITHIN THE WTU. A. AC SOLDIERS. AC SOLDIERS CAN ONLY BE AUTHORIZED A RENTAL CAR PRIOR TO BEING PCS TO THE HOSPITAL WHILE THEY ARE STILL IN A TDY STATUS. ONCE AN AC SOLDIER IS PCS TO THE HOSPITAL, THEY ARE AUTHORIZED TO BRING THEIR PRIVATELY OWNED VEHICLE (POV) TO THE HOSPITAL WHICH IS THEIR NEW PDS. THERE NO AUTHORITY TO ALLOW A RENTAL CAR AT A SOLDIER’S PDS. APPROVAL AUTHORITY FOR A RENTAL CAR IS THE FIRST COLONEL COMMANDER IN THE HOSPITAL/WTU CHAIN OF COMMAND. PRIOR TO AUTHORIZING A RENTAL CAR, COMMANDERS MUST ENSURE THE ATTENDING PHYSICIAN HAS CLEARED THE SOLDIER TO DRIVE. TO PAY FOR RENTAL CARS, HOSPITAL /WTU COMMANDERS WILL ACCOUNT FOR THIS EXPENDITURE AS A COST ASSOCIATED WITH THE GLOBAL WAR ON TERROR AND AMEND THE SOLDIER’S TCS ORDERS TO REFLECT THE RENTAL CAR AUTHORIZATION AND CHARGING THE COSTS. RENTAL CARS WILL ONLY BE AUTHORIZED FOR UP TO A MAXIMUM OF 30 DAY INCRAMENTS.

B. RC SOLDIERS. NORMALLY, RC SOLDIERS CAN BE AUTHORIZED A RENTAL CAR FOR THE DURATION OF THE STAY IN THE WTU BECAUSE IN MOST CASES, THEY ARE ASSIGNED TO THE HOSPITAL AND WTU IN A TDY STATUS. APPROVAL AUTHORITY FOR A RENTAL CAR IS THE FIRST COLONEL COMMANDER IN THE HOSPITAL/WTU CHAIN OF COMMAND. PRIOR TO AUTHORIZING A RENTAL CAR, COMMANDERS MUST ENSURE THE ATTENDING PHYSICIAN HAS CLEARED THE SOLDIER TO DRIVE. TO PAY FOR RENTAL CARS, HOSPITAL /WTU COMMANDERS WILL ACCOUNT FOR THIS EXPENDITURE AS A COST ASSOCIATED WITH THE GLOBAL WAR ON TERROR AND AMEND THE SOLDIER’S TCS ORDERS TO REFLECT THE RENTAL CAR AUTHORIZATION. RENTAL CARS WILL ONLY BE AUTHORIZED TO FOR A MAXIMUM OF 30 DAY INCRAMENTS. IF FOR SOME UNUSUAL REASON, A RC SOLDIER IS PCS TO THE HOSPITAL, THE AC RULES IN A ABOVE APPLY AND NO RENTAL CAR CAN BE AUTHORIZED. TO PAY FOR RENTAL CARS, HOSPITAL /WTU COMMANDERS WILL ACCOUNT FOR

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THIS EXPENDITURE AS A COST ASSOCIATED WITH THE GLOBAL WAR ON TERROR AND AMEND THE SOLDIER’S 10 USC 12301(D) ORDERS TO REFLECT THE RENTAL CAR AUTHORIZATION AND CHARGING THE COSTS. RENTAL CARS WILL ONLY BE AUTHORIZED FOR UP TO A MAXIMUM OF 30 DAY INCRAMENTS.

16. WTU SOLDIERS MAY BE AUTHORIZED REIMBURSEMENT FOR LOCAL TRAVEL TO ALTERNATE DUTY LOCATIONS TO ATTEND MEDICAL APPOINTMENTS.

A. AC SOLDIERS. IN ACCORDANCE WITH (IAW) JFTR, PARARGRAPHS U3505 AND U3510 REIMBURSEMENT FOR MILEAGE FOR TRAVEL TO AN ALTERNATE DUTY LOCATION (TDY OR PCS DUTY LOCATION) MAY BE AUTHORIZED TO ATTEND MEDICAL APPOINTMENTS. APPROVAL AUTHORITY FOR MILEAGE REIMBURSEMENT IS THE FIRST COLONEL COMMANDER IN THE HOSPITAL/WTU CHAIN OF COMMAND.

1. AC SOLDIERS WHO ARE STILL IN TDY STATUS. TO PAY FOR THIS MILEAGE REIMBURSEMENT, HOSPITAL /WTU COMMANDERS WILL ACCOUNT FOR THIS EXPENDITURE AS A COST ASSOCIATED WITH THE GLOBAL WAR ON TERROR AND AMEND THE SOLDIER’S TCS ORDERS TO REFLECT THE MILEAGE REIMBURSEMENT AUTHORITY.

2. AC SOLDIERS WHO HAVE BEEN PCS TO THE HOSPITAL. TO PAY FOR THIS MILEAGE REIMBURSEMENT, HOSPITAL /WTU COMMANDERS WILL ACCOUNT FOR THIS EXPENDITURE AS A COST ASSOCIATED WITH THE GLOBAL WAR ON TERROR. HOSPITAL/WTU COMMANDERS ISSUE SOLDIERS DD FORM 1610 TO SUBSTANTIATE TO SUBSTANTIATE THIS REIMBURSEMENT.

B. RC SOLDIERS. FOR THE MOST PART, RC SOLDIERS REMAIN IN THE WTU IN A TDY STATUS. APPROVAL AUTHORITY FOR MILEAGE REIMBURSEMENT IS THE FIRST COLONEL COMMANDER IN THE HOSPITAL/WTU CHAIN OF COMMAND. TO PAY FOR THIS MILEAGE REIMBURSEMENT, HOSPITAL /WTU COMMANDERS WILL ACCOUNT FOR THIS EXPENDITURE AS A COST ASSOCIATED WITH THE GLOBAL WAR ON TERROR AND AMEND THE SOLDIER’S 10 USC 12301(D) ORDERS TO REFLECT THE MILEAGE REIMBURSEMENT AUTHORITY. 17. TIMELY PROCESSING OF PAY DOCUMENTS FOR SOLDIERS WITHIN WTU.

A. GENERAL. THE ARMY MUST ENSURE ACCURATE AND TIMELY DELIVERY OF SOLDIERS’ MILITARY AND TRAVELY PAYS, AND TRAVEL PAY TO FAMILY MEMBERS AND CARE GIVERS UNDER INVITATIONAL TRAVEL/NON MEDICAL ATTENDANT ORDERS. THE TIMELY DELIVERY OF PAY IS A PARTNERSHIP BETWEEN THE RESPONSIBLE PAY AUTHORITIES

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(I.E. HOUSING OFFICE, HOSPITAL/WTU/UNIT COMMANDER, HRC, IMCOM, AND MEDCOM) AND THE RESPONBSILBE FINANCE OFFICE (ARMY FINANCE UNIT, DEFENSE FINANCE AND ACCOUNTING SERVICE MILITARY PAY OFFICE, UNITED STATES PROPERTY AND FISCAL OFFICE, AND UNITED STATES ARMY PAY CENTERS). RECENT GAO AND AAA STUDIES AND INVESTIGATIONS HAVE INDICATED THAT PAY TIMELINESS PROBLEMS ARE PREDOMINATELY DUE TO LATE RECEIPT OF PAY GENERATING DOCUMENTS AT THE SERVICING FINANCE OFFICE.

B. STANDARD. IT IS IMPERATIVE THAT EACH PARTICIPANT IN THE CHAIN OF COMMAND UNDERSTAND THE REGULATORY AND POLICY STANDARDS THAT GOVERN THEIR CONTRIBUTION TO PAY TIMELINESS AND ACCURACY, AND EMPLOY PROPER PERFORMANCE STANDARDS AND CORRESPONDING METRICS TO ENSURE COMPLIANCE. WHERE REGULATORY AND POLICY GUIDANCE DO NOT OTHERWISE EXIST, THIS MESSAGE ESTABLISHES THE FOLLOWING STANDARD FOR SUPPORT: ALL AUTHORIZING DOCUMENTS FOR MILITARY AND TRAVEL PAY AND ALLOWANCES (I.E. ORDERS, PERSONNEL ACTIONS) MUST BE DELIVERED TO THE SERVICING FINANCE OFFICE NO LATER THAN 10 CALENDAR DAYS PRIOR TO THE EFFECTIVE DATE OF THE PAY AFFECTING ACTION. ARMY COMMANDS, ARMY SERVICE COMPONENT COMMANDS, AND DIRECT REPORTING UNITS MUST ENSURE THEIR SUBORDINATE ACTIVITIES PROPERLY ADDRESS PAY TIMELINESS AND ACCURACY. ALL LEADERSHIP LEVELS MUST ESTABLISH APPROPRIATE METRICS TO MANAGE THIS CRITICAL STANDARD OF SUPPORT TO OUR SOLDIERS AND THEIR FAMILIES. 18. ARMY MANAGEMENT CONTROLPROCESS: COMMANDERS ARE REMINDED TO ESTABLISH AND EXERCISE MANAGEMENT CONTROL AND MANAGEMENT CONTROL EVALUATION PROCEDURES AS PRESCRIBED BY GOVERNING REGULATIONS. 19. RESPONSIBILITIES: ARMY COMMANDERS, INCLUDING COMMANDERS OF A MTF WILL ESTABLISH PROCEDURES WITH THEIR INSTALLATIONS COMMANDERS AND WTU COMMANDERS TO ENSURE SOLDIERS ACCOUNTABILITY, DUTY STATUS AND ACCURATE PAY. THE DEFENSE FINANCE AND ACCOUNTING SERVICE (DFAS) WILL ASSIST THE MEDICAL COMMANDS ADMINISTRATIVE PERSONNEL IN ESTABLISHING PROCEDURES TO PROPERLY ACCOUNT FOR WOUNDED SOLDIER'S PAY STATUS, AND MAINTAIN AND UPDATE MHO SOLDIERS MILITARY PAY AND TRAVEL RECORDS TO ENSURE SOLDIERS PAY ACCOUNTS ARE PAID CORRECTLY. 20. THE OVERALL POINT OF CONTACT FOR THIS MESSAGE IS MRS. MCCLELLAND, DSN 221-9005 OR COMMERCIAL (703) 325-9005; EMAIL BRENDA.MCCLELLAND@CONUS.ARMY.MIL).

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(A) ARMY G-1, COMPENSATION & ENTITLEMENTS POINT OF CONTACT IS LTC VOITHOFER; EMAIL MATHTHEW.VOITHOFER@US.ARMY.MIL. (B) POINT OF CONTACT FOR MEDICAL POLICY, IS LTC BAUER, HQDA, DCS, G-1, DAPE-MPE-DR, (703) 695-7874; EMAIL ANNE.BAUER@HQDA.ARMY.MIL AND MSG CARMEL, HQDA, DCS, G-1, DAPE-MPE-DR, (703) 695-7864; EMAIL MICHAEL.CARMEL@HQDA.ARMY.MIL. (C) POINT OF CONTACT FOR U.S. ARMY WOUNDED WARRIORS PROGRAM IS LTC CLARK, (703) 325-8454; EMAIL BOB.CLARK@CONUS.ARMY.MIL AND MAJ CISNEY (703) 325-9953; EMAIL DEB.CISNEY@CONUS.ARMY.MIL. (D) POINT OF CONTACT FOR ENLISTED PERSONNEL IS MRS. ADCOCK-DODD, (703) 325-2730; EMAIL ADCOCK.DODD@CONUS.ARMY.MIL. (E) POINT OF CONTACT FOR OFFICER PERSONNEL MANAGEMENT DIRECTORATE IS MR. MCKNIGHT, (703) 325-5191; EMAIL THOMAS.MCKNIGHT@CONUS.ARMY.MIL.

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http://PERSCOMND04.ARMY.MIL/MILPERmsgs.nsf/All+Documents/07-075?OpenDocument D-2-5 MILPER MESSAGE NUMBER: 05-273 AHRC-PED-S LINE OF DUTY (LOD) POST DEPLOYMENT HEALTH REASSESSMENT POLICY ...Issued: [11/03/2005]... REFERENCES. A. MILPER MESSAGE 04-341, 28 JUN 03, SUBJECT: LINE OF DUTY (LOD) CONTINGENCY OPERATIONS POLICY. B. ASSISTANT SECRETARY OF DEFENSE FOR HEALTH AFFAIRS MEMORANDUM, DATED 10 MARCH 2005, SUBJECT: POST-DEPLOYMENT HEALTH REASSESSMENT PROGRAM. 1. THIS MESSAGE SUPPLEMENTS AR 600-8-4, LINE OF DUTY POLICY, PROCEDURES, AND INVESTIGATIONS AND WILL EXPIRE 30 NOVEMBER 2007. 2. RESERVE COMPONENT SOLDIERS (USAR AND ARNG) WHO HAVE RETURNED FROM DEPLOYMENT IN A COMBAT ZONE (OIF/OEF) MUST BE EVALUATED BY A MEDICAL PROVIDER (PHYSICIAN, PHYSICIAN’S ASSISTANT OR NURSE PRACTIONER) DURING THE COMPLETION OF A POST-DEPLOYMENT HEALTH REASSESSMENT (PDHRA). IF THE PDHRA SCREENING REVEALS A NEED FOR MEDICAL CONSULTATION, A DA FORM 2173, STATEMENT OF MEDICAL EXAMINATION AND DUTY STATUS WILL BE PROCESSED.

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3. THE DA FORM 2173, STATEMENT OF MEDICAL EXAMINATION AND DUTY STATUS WILL BE INITIATED AND COMPLETED AS PART OF THE PDHRA PROCESS. A. PART I, WILL BE COMPLETED BY THE MEDICAL PROVIDER AS IDENTIFIED IN PARAGRAPH 2. B. SECTION 10, WILL SPECIFY “THIS MEDICAL EVALUATION WILL BE COMPLETED IAW SECDEF PDHRA DIRECTIVE.” C. SECTION 30, “SOLDIER REQUIRES FURTHER MEDICAL EVALUATION IAW WITH PDHRA DIRECTIVE.” D. PART II OF DA 2173 WILL BE SIGNED BY THE UNIT COMMANDER OR HIS/HER DESIGNEE. THE SIGNATURE VERIFIES THE SOLDIER’S PARTICIPATION IN A CONTINGENCY OPERATION. 4. A REVIEW WILL BE COMPLETED BY THE RESERVE COMPONENT MEDICAL AUTHORITY (READY RESERVE COMPONENT SURGEON, STATE SURGEON OR DESIGNEE) OF THE RESULTS OF THE MEDICAL EVALUATION REFERENCED IN PARAGRAPH 3. A NEW DA 2173, STATEMENT OF MEDICAL EXAMINATION AND DUTY STATUS WILL BE INITIATED AND COMPLETED TO DOCUMENT THE FINDING OF IN THE LINE OF DUTY (ILOD). IF THE DETERMINATION IS NOT IN THE LINE OF DUTY (NLD) A DD FORM 261 (FORMAL LOD) MUST BE INITIATED. A. PART I, OF THE NEW DA 2173 WILL BE COMPLETED BY THE MEDICAL PROVIDER AS IDENTIFIED IN PARAGRAPH 2. B. BLOCK 10, OF THE NEW DA 2173 WILL SPECIFY “THIS MEDICAL TREATMENT WILL BE COMPLETED IAW SECDEF PDHRA DIRECTIVE.” C. BLOCK 15, OF THE NEW DA 2173 WILL BE COMPLETED BY THE RC MEDICAL AUTHORITY. THE FOLLOWING STATEMENT WILL BE COMPLETED BY THE RC MEDICAL AUTHORITY: “THE SOLDIER WILL RECEIVE MEDICAL TREATMENT FOR (LIST DIAGNOSIS) WHICH WAS IDENTIFIED THROUGH THE PDHRA SCREENING PROCESS AS DUTY RELATED.” D. BLOCK 30, OF THE NEW DA 2173 “SOLDIER REQUIRES MEDICAL CARE FOR A CONDITION IDENTIFIED IAW SECDEF PDHRA DIRECTIVE.” E. PART II OF THE NEW DA 2173 WILL BE SIGNED BY THE FIRST GENERAL COURT MARTIAL CONVENING AUTHORITY OR HIS/HER DESIGNEE. 5. POINT OF CONTACT. MRS. COURDUFF AT ARMY CASUALTY AND MEMORIAL AFFAIRS OPERATIONS CENTER (CMAOC), DSN 221-5302, COMMERCIAL (703)325-5302 OR BY FAX AT EXTENSION - 1844. EMAIL ADDRESS: GISELA.COURDUFF@CONUS.ARMY.MIL

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D-2-6 MILPER: 07-179 AHRC-EPO-P WARRIOR TRANSITION UNIT CADRE PERSONNEL (ASSIGNMENT AND STABILIZATION OF ACTIVE COMPONENT SOLDIERS) ...Issued: [07/17/2007]...

REFERENCE: ALARACT MESSAGE NUMBER 135/2007, DAPE-MPE, SUBJECT: INITIAL PERSONNEL POLICY GUIDANCE FOR ASSIGNMENT AND ATTACHMENT TO WARRIOR TRANSITION UNITS (WTU), DATED 14 JUN 07. 1. REFERENCE ABOVE PROVIDES THE POLICY GUIDANCE FOR ASSIGNING SOLDIERS TO WARRIOR TRANSITION UNITS (WTU). THE PURPOSE OF THIS MESSAGE IS TO PROVIDE PROCEDURAL GUIDANCE FOR ASSIGNMENT OF CADRE PERSONNEL TO THE WTU, INFORMATION REGARDING STABILIZATION OF CADRE PERSONNEL, USE OF ASSIGNMENT ELIGIBILITY AND AVAILABILITY (AEA) CODES, AND TO REITERATE THE DEFINITION OF A “WARRIOR IN TRANSITION.” 2. IN ORDER TO PROVIDE THE DESIRED STABILIZATION AND COHESION IN THE WTU CADRE ORGANIZATIONS, ACTIVE COMPONENT FILL WILL COME PRIMARILY FROM INSTALLATIONS WHERE THE WTUS ARE LOCATED. HRC WILL BACKFILL LOSING UNITS IN ACCORDANCE WITH MANNING GUIDANCE. USING THE GUIDELINES BELOW, SENIOR MISSION COMMAND G-1 WILL IDENTIFY QUALIFIED SOLDIERS FROM THEIR CURRENT POPULATION AND COORDINATE WITH HRC FOR REASSIGNMENT (NOT ATTACHMENT) TO THE CADRE POSITIONS. SUSPENSE FOR REPORTING POSITIONS WHICH CANNOT BE FILLED FROM THE INSTALLATION IS 30 SEP 07 TO HRC, EPMD (MAJ HELLERSTEDT) OR OPMD (LTC CURRIERA). CADRE POSITIONS THAT CANNOT BE FILLED BY THE INSTALLATION WILL BE FILLED THROUGH HRC PROVIDED ASSIGNMENT INSTRUCTION (AI). HRC PROJECTS FILL NET 120 DAYS FROM RECEIPT OF APPROVED TDA OR 120 DAYS FROM INSTALLATION NOTIFICATION OF INABILITY TO FILL CADRE POSITIONS (WHICHEVER IS LATER). WARRIOR TRANSITION UNIT CONSOLIDATED GUIDANCE (WTUCG) (RENAMED FROM MHOCG ON 22 JUN 07; THESE DOCUMENTS CAN BE FOUND AT THE FOLLOWING WEB SITE HTTP://WWW.ARMYG1.ARMY.MIL ). A. ALL REASSIGNMENTS TO CADRE WTU UNITS MUST BE COORDINATED THROUGH HRC AND WILL REQUIRE AN HRC-GENERATED ASSIGNMENT INSTRUCTION/REQUEST FOR ORDERS. B. SOLDIERS ON ASSIGNMENT INSTRUCTIONS OR IN RECEIPT OF REQUESTS FOR ORDERS TO OTHER UNITS WILL NOT BE USED FOR WTU CADRE REQUIREMENTS UNLESS COORDINATED AND APPROVED BY HRC. C. USE OF QUALIFIED NONAVAILABLE/NONDEPLOYABLE SOLDIERS IS

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ENCOURAGED AND WILL BE AUTHORIZED BY EXCEPTION, ON A CASE-BY-CASE BASIS. D. ALTHOUGH ATTEMPTS WILL BE MADE TO ACHIEVE GRADE AND SKILL MATCH, IT IS UNDERSTOOD THAT THE INTENT IS TO BUILD CADRE UNITS WITH QUALIFIED NCOS AND OFFICERS. 3. MEDICAL TREATMENT FACILITY (MTF) COMMANDERS WILL ENSURE THAT ALL WTU CADRE PERSONNEL ARE ASSIGNED TO THE APPROPRIATE WTU OPERATIONAL UIC/DUIC, AND NOT TO THE PATIENT ACCOUNTING UIC FOR MANAGING TRANSITIONING WARRIORS. 4. CADRE ASSIGNMENT ELIGIBILITY AND AVAILABILITY (AEA) CODES: A. CURRENT AEA CODES SHOULD NOT PRECLUDE ASSIGNMENT TO A WTU FOR SOLDIERS IDENTIFIED ON THE INSTALLATION. HRC, EPMD WILL IMPLEMENT A WEEKLY CLEAN-UP ACTION TO REMOVE TOP-OF-SYSTEM GENERATED AEA CODES; FIELD-GENERATED AEA CODES SHOULD BE REMOVED OR RETAINED AS DETERMINED LOCALLY. B. CADRE PERSONNEL ASSIGNED TO THE WTU WILL BE STABILIZED FOR 24 MONTHS UPON THEIR ARRIVAL USING THE AEA CODE “W” (ORGANIZATIONAL STABILIZATION). G1/S1 SECTIONS OR MILITARY PERSONNEL UNITS WILL ENSURE AEA CODES AND TERMINATION DATES ARE POSTED IN A TIMELY MANNER. 5. EXPECT APPROVED STRUCTURE (UIC AND MOS, GRADE, SKILL) TO BE RELEASED IN THE AUG 07 PMAD. 6. A “WARRIOR IN TRANSITION” (SOLDIERS BEING ASSIGNED TO THE NON-CADRE UICS) IS DEFINED IN REFERENCE ABOVE AS AN ACTIVE COMPONENT OR RESERVE COMPONENT SOLDIER WHO MEETS THE QUALIFICATIONS FOR MEDICAL HOLD, MEDICAL HOLDOVER, OR ACTIVE DUTY MEDICAL EXTENSION IAW DA PPG AND MHOCG. IT ALSO INCLUDES ACTIVE COMPONENT SOLDIERS WHO REQUIRE A MEDICAL EVALUATION BOARD (MEB) OR HAVE A COMPLEX MEDICAL NEED REQUIRING GREATER THAN 6 MONTHS OF TREATMENT. WARRIORS IN TRANSITION DO NOT INCLUDE INITIAL ENTRY TRAINING, ADVANCED INDIVIDUAL TRAINING, OR ONE STATION UNIT TRAINING SOLDIERS EXCEPT IN EXTRAORDINARY CIRCUMSTANCES. WARRIORS IN TRANSITION UNITS WILL NOT BE FILLED BY SOLDIERS UNDERGOING LEGAL PROCESSING, SOLDIERS WHO HAVE BEEN RETAINED OR RECLASSIFIED BY THE MMRB, SOLDIERS WHO HAVE BEEN RETAINED BY THE MEB OR FOUND FIT BY THE PEB, OR SOLDIERS WHOSE MEDICAL NEEDS ARE SOLELY RELATED TO PREGNANCY. 7. THE HRC, EPMD POC IS MAJ RYAN HELLERSTEDT, 703-325-4402 (DSN 221),

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RYAN.HELLERSTEDT@CONUS.ARMY.MIL OR LTC DEBRA HANNEMAN, 703-325-4678 (DSN 221), DEBRA.A.HANNEMAN@CONUS.ARMY.MIL . HRC, OPMD POC IS LTC CARL CURRIERA. 703-325-5199, (CARL.CURRIERA@CONUS.ARMY.MIL ). ISSUES INVOLVING BOTH OFFICERS AND ENLISTED SOLDIERS CAN BE ADDRESSED TO COL WES GILLMAN, 703-325-3888 (WESLEY.GILLMAN@CONUS.ARMY.MIL ).

UNCLASSIFIED// D-2-7 ALARACT 134/2006 SUBJECT: COMBAT-RELATED INJURY REHABILITATION PAY (CIP) POLICY 1. REFERENCES. A. NATIONAL DEFENSE AUTHORIZATION ACT FOR FISCAL YEAR 2006 (NDAA), SEC 642. B. MEMORANDUM, UNDER SECRETARY OF DEFENSE FOR PERSONNEL AND READINESS (USD(P&R)), SUBJECT: AVAILABILITY OF SPECIAL PAY FOR MEMBERS DURING REHABILITATION FROM WOUNDS, INJURIES, AND ILLNESSES INCURRED IN A COMBAT OPERATION OR COMBAT ZONE DESIGNATED BY THE SECRETARY OF DEFENSE, DATED MARCH 23, 2006. 2. PURPOSE. THIS MESSAGE ANNOUNCES THE NEW SPECIAL PAY AUTHORIZED BY THE NDAA FOR FY2006. COMBAT-RELATED INJURY REHABILITATION PAY (CIP) IS A SPECIAL PAY FOR SOLDIERS WHO, IN THE LINE OF DUTY, INCUR WOUNDS, INJURIES, OR ILLNESSES IN A COMBAT OPERATION OR COMBAT ZONE DESIGNATED BY THE SECDEF AND ARE EVACUATED FROM THE THEATER FOR MEDICAL TREATMENT. SOLDIERS MAY RECEIVE CIP DURING A PORTION OF THEIR REHABILITATION. SOME SPECIAL PAYS RECEIVED IN THE COMBAT ZONE CEASE WHEN HOSPITALIZED AND/OR PLACED ON PCS REASSIGNMENT. THIS ENTITLEMENT ALLOWS SOLDIERS THE OPPORTUNITY TO ADJUST TO THE FUTURE REDUCTION OF PAY BENEFITS THEY WERE ENTITLED TO IN THE COMBAT ZONE PRIOR TO BEING EVACUATED FOR MEDICAL TREATMENT. 3. ELIGIBILITY FOR COMBAT-RELATED INJURY REHABILITATION PAY (CIP). A. THE CIP WILL BE PAID TO ELIGIBLE SOLDIERS WHO, WHILE IN THE LINE OF DUTY, INCUR A WOUND, INJURY OR ILLNESS IN A COMBAT OPERATION OR COMBAT ZONE DESIGNATED BY THE SECDEF (SEE PARA 4 AND 5 BELOW) AND ARE EVACUATED FROM THE THEATER OF COMBAT OPERATION OR COMBAT ZONE FOR MEDICAL TREATMENT. SOLDIER MUST

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BE HOSPITALIZED, AS DEFINED IN PARAGRAPH 6 BELOW, TO BE ELIGIBLE FOR CIP. B. A WOUND, INJURY OR ILLNESS WILL BE CONSIDERED TO HAVE BEEN INCURRED IN THE LINE OF DUTY UNLESS IT WAS THE RESULT OF THE SOLDIERS OWN INTENTIONAL MISCONDUCT OR WILLFUL NEGLIGENCE, OR INCURRED DURING A PERIOD OF UNAUTHORIZED ABSENCE. 4. DESIGNATION OF COMBAT OPERATIONS AND COMBAT ZONES. COMBAT ZONES DESIGNATED BY THE SECRETARY OF DEFENSE FOR CIP PURPOSES ARE THOSE GEOGRAPHIC LOCATIONS DESIGNATED BY THE PRESIDENT AS COMBAT ZONES. CURRENT COMBAT ZONES ARE LISTED BELOW. THEY ARE ALSO LISTED IN DOD FMR, VOL 7A, CHAPTER 44. FUTURE ADDITIONS AND DELETIONS OF DESIGNATED COMBAT ZONES WILL BE REFLECTED IN THE DOD FMR, VOL 7A, CHAPTER 44. A. EXECUTIVE ORDER 12744, EFFECTIVE 17 JANUARY 1991: ARABIAN SEA PORTION THAT LAYS NORTH OF 10 DEGREES NORTH LATITUDE AND WEST OF 68 DEGREES EAST LONGITUDE BAHRAIN GULF OF ADEN GULF OF OMAN IRAQ KUWAIT PERSIAN GULF QATAR OMAN RED SEA SAUDI ARABIA UNITED ARAB EMIRATES B. EXECUTIVE ORDER 13119, EFFECTIVE 24 MARCH 1999: THE FEDERAL REPUBLIC OF YUGOSLAVIA (SERBIA/MONTENEGRO) ALBANIA THE ADRIATIC SEA THE IONIAN SEA NORTH OF THE 39TH PARALLEL C. EXECUTIVE ORDER 13239, EFFECTIVE 19 SEPTEMBER 2001: AFGHANISTAN. 5. COMBAT OPERATIONS (I.E., A MILITARY OPERATION CONDUCTED AGAINST A HOSTILE FORCE) CURRENTLY DESIGNATED BY THE SECDEF FOR CIP PURPOSES ARE OPERATION ENDURING FREEDOM (OEF) AND OPERATION IRAQI FREEDOM (OIF). THE SECDEF MAY DESIGNATE OTHER OPERATIONS AS COMBAT OPERATIONS; NECESSARY PAPERWORK REFLECTING SUCH A DESIGNATION MAY BE PREPARED AFTER THE FACT. SOLDIERS ISSUED ORDERS WITH OEF AND OIF MUST BE IN DIRECT SUPPORT OF COMBAT OPERATIONS TO BE ELIGILBLE FOR CIP.

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6. SOLDIERS ARE CONSIDERED HOSPITALIZED FOR PURPOSES OF CIP IF ONE OF THE BELOW CRITERIA EXIST: (1) THE SOLDIER IS AN INPATIENT IN A MILITARY TREATMENT FACILITY (MTF) OR A FACILITY UNDER THE AUSPICES OF THE MILITARY HEALTH CARE SYSTEM. (2) THE SOLDIER IS AN OUTPATIENT RECEIVING EXTENSIVE REHABILITATION OR OTHER MEDICAL CARE IN AN MTF OR A FACILITY UNDER THE AUSPICES OF THE MILITARY HEALTH CARE SYSTEM AND IS RESIDING IN A FACILITY AFFILIATED WITH THE MTF; FOR EXAMPLE, A FISHER HOUSE, MOLOGNE HOUSE, BARRACKS CONSTRUCTED FOR THE PURPOSE OF HOUSING SOLDIERS WHILE AFFILIATED WITH THE MTF OR A CONTRACTED FACILITY (SUCH AS A HOTEL). SOLDIERS RESIDING PLACES OTHER THAN UNDER THE AUSPICES OF THE MTF (FOR EXAMPLE, SOLDIER IN HIS OR HER PRIVATE RESIDENCE) ARE NOT CONSIDERED TO BE RESIDING IN A FACILITY UNDER THE AUSPICES OF THE MILITARY HEALTH CARE SYSTEM AND ARE THUS NOT ELIGIBLE FOR CIP. 7. AMOUNTS OF CIP. THE ENTITLEMENT TO CIP IS $430 MONTHLY LESS PAYMENT RECEIVED BY THE SOLDIER FOR THE SAME MONTH UNDER SECTION 310B OF TITLE 37 OF THE UNITED STATES CODE (37 USC 310(B)), HOSTILE FIRE/IMMINENT DANGER PAY (HF/IDP). 37 USC 310(B) AUTHORIZES THE CONTINUATION OF HF/IDP ($225/MONTH) FOR UP TO THREE ADDITIONAL MONTHS FOR SOLDIERS HOSPITALIZED FOR THE TREATMENT OF AN INJURY OR WOUND INCURRED AS A RESULT OF HOSTILE FIRE, EXPLOSION OF A HOSTILE MINE, OR ANY OTHER HOSTILE ACTION; OR HOSPITALIZED FOR A WOUND, INJURY, OR ILLNESS INCURRED IN THE LINE OF DUTY IN A SECDEF DESIGNATED COMBAT OPERATION OR COMBAT ZONE. 8. CIP AND HF/IDP ARE PAYABLE IN ADDITION TO ANY OTHER PAY AND ALLOWANCES TO WHICH THE SOLDIER IS ENTITLED. CIP AND HF/IDP WILL BE PAID AT THE APPLICABLE MONTHLY RATE. NEITHER CIP NOR HF/IDP WILL BE PRORATED. 9. PAYMENT VERIFICATION. IDENTIFICATION OF SOLDIERS AND VERIFICATION OF ENTITLEMENT WILL BE COORDINATED BETWEEN THE MEDICAL AND PERSONNEL COMMUNITY. WHEN ENTITLEMENT IS VERIFIED, THE MEDICAL COMMUNITY I.E., OTSG WILL TRANSMIT THE DATA TO DFAS-IN, ARMY MILITARY PAY OPERATIONS FOR PAYMENT OR TERMINATION. UNTIMELY NOTIFICATION OF STATUS CHANGES MAY RESULT IN OVERPAYMENTS TO SOLDIERS, POTENTIALLY CAUSING THE SOLDIER UNNECESSARY INCONVENIENCE AND POTENTIAL HARDSHIP AND ADDITIONAL WORKLOAD IN THE PERSONNEL/PAY SYSTEM. 10. CIP PAYMENTS.

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A. COMMENCEMENT OF PAYMENT. PAYMENTS FOR CIP SHALL COMMENCE TO AN ELIGIBLE SOLDIER THE MONTH BEGINNING AFTER THE DATE ON WHICH THE MEMBER IS EVACUATED FROM THE THEATER OF COMBAT OPERATION OR THE COMBAT ZONE FOR MEDICAL TREATMENT. IT MAY BE PAID TO SOLDIERS WHO INCURRED A QUALIFYING WOUND, INJURY, OR ILLNESS PRIOR TO 23 MARCH 2006 (THE DATE OF THE USD(P&R) CIP IMPLEMENTATION MEMORANDUM), AS LONG AS THE SOLDIER CONTINUED TO BE ELIGIBLE FOR CIP ON 23 MARCH 2006. HOWEVER, IN NO CASE ARE SOLDIERS ELIGIBLE FOR CIP PRIOR TO 23 MARCH 2006. THUS, THE FIRST CIP PAYMENT FOR THESE SOLDIERS WOULD BE 1 APRIL 2006 (PROVIDED THE SOLDIERS REMAINED ELIGIBLE FOR CIP ON 1 APRIL 2006). B. TERMINATION OF PAYMENT. (1) THE CIP WILL TERMINATE AT THE END OF THE FIRST MONTH DURING WHICH ANY OF THE FOLLOWING APPLY; CIP WILL NOT BE PRORATED FOR THE LAST MONTH OF PAYMENT. (A) SOLDIER IS PAID A BENEFIT UNDER TRAUMATIC SERVICEMEMBERS GROUP LIFE INSURANCE (T-SGLI) 38 USC, SEC 1980A. (B) SOLDIER RECEIVES NOTIFICATION OF THE ELIGIBILITY FOR A BENEFIT UNDER T-SGLI AND A PERIOD OF 30 DAYS EXPIRES AFTER THE DATE OF SUCH NOTIFICATION. T-SGLI APPROVAL NOTIFICATION WILL SERVE AS NOTIFICATION OF ELIGIBILITY. (C) SOLDIER IS NO LONGER HOSPITALIZED AS DEFINED IN PARAGRAPH 6, ABOVE. (2) ONCE A SOLDIER IS NO LONGER ELIGIBLE FOR CIP IN CONNECTION WITH AN INCURRED WOUND, INJURY OR ILLNESS (FOR EXAMPLE, SOLDIER IS DISCHARGED FROM THE HOSPITAL), ELIGIBILITY FOR CIP TERMINATES AND CANNOT BE REESTABLISHED IN CONNECTION WITH THAT SAME INJURY, WOUND OR ILLNESS EVEN IF THE SOLDIER IS REHOSPITALIZED AT A LATER DATE FOR FURTHER MEDICAL TREATMENT. HOWEVER, IF THE SOLDIER IS SUBSEQUENTLY ASSIGNED IN A COMBAT OPERATION OR COMBAT ZONE AND AGAIN INCURS A WOUND, INJURY OR ILLNESS AND IS EVACUATED FOR MEDICAL TREATMENT, SOLDIER COULD AGAIN BE ELIGIBLE FOR CIP. (3) HUMAN RESOURCES COMMAND (HRC), PHYSICAL DISABILITY AGENCY (PDA), TRAUMATIC SERVICEMEMBERS GROUP LIFE INSURANCE (T-SGLI) DIVISION WILL PROVIDE DATA TO OTSG OF SOLDIERS THAT HAVE BEEN APPROVED FOR T-SGLI BI-MONTHLY. (4) THE MEDICAL COMMUNITY WILL IDENTIFY SOLDIERS NO LONGER ELIGIBLE FOR CIP AND TRANSMIT DATA TO DFAS THAT: (A) ARE NO LONGER HOSPITALIZED , AS DEFINED IN PARAGRAPH 6, ABOVE. (B) HAVE RECEIVED THE T-SGLI BENEFITS, OR (C) HAVE BEEN NOTIFIED IN WRITING OF PENDING T-SGLI PAYMENT OF BENEFITS PLUS A PERIOD OF 30 DAYS HAS EXPIRED. C. EXAMPLES FOR CIP PAYMENT ARE:

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(1) SOLDIER EVACUATED FROM CZ 27 NOVEMBER 2005 FOR MEDICAL TREATMENT AND REMAINED HOSPITALIZED THROUGH 15 MAY 2006 = CIP PAYMENT DUE TO SOLDIER FOR APRIL AND MAY 2006. (2) SOLDIER EVACUATED FROM CZ FOR MEDICAL TREATMENT 1 MAY 2006 AND REMAINED HOSPITALIZED THROUGH 2JULY 2006 = CIP PAYMENT DUE TO MEMBER FOR JUNE AND JULY 2006. (3) SOLDIER EVACUATED FROM CZ FOR MEDICAL TREATMENT ON 31 MAY 2006 AND REMAINED HOSPITALIZED THROUGH 14 JUNE 2006 = CIP PAYMENT DUE TO SOLDIER FOR JUNE 2006. (4) SOLDIER EVACUATED FROM CZ FOR MEDICAL TREATMENT 2 JUNE AND REMAINED HOSPITALIZED THROUGH 28 JUNE 2006 = NO CIP PAYMENT DUE. (5) SOLDIER EVACUATED FROM CZ FOR MEDICAL TREATMENT ON 10 FEBRUARY 2006 AND RECEIVED T-SGLI PAYMENT 15 MARCH 2006, REMAINED HOSPITALIZED THROUGH 10 APRIL 2006 = NO CIP PAYMENT DUE TO SOLDIER. (6) SOLDIER EVACUATED FROM CZ FOR MEDICAL TREATMENT ON 22 MARCH 2006, SOLDIER WAS NOTIFIED 10 APRIL 2006 THAT SHE WOULD RECEIVE T-SGLI PAYMENT, AND SOLDIER RECEIVED T-SGLI PAYMENT 28 APRIL 2006. CIP PAYMENT DUE TO SOLDIER FOR APRIL 2006. (7) SOLDIER EVACUATED FROM CZ FOR MEDICAL TREATMENT ON 5 APRIL 2006, IN HOSPITAL AT WRAMC UNTIL 25 MAY 2006, SOLDIER MOVES INTO THE MOLOGNE HOUSE FOR CONTINUED OUTPATIENT TREATMENT AT WRAMC, SOLDIER MOVES TO HIS/HER HOME IN TOWSON, MD ON CONVALESCENT LEAVE ON 20 JUNE 2006 = CIP PAYMENT DUE TO SOLDIER FOR MAY AND JUNE 2006. 11. AUDIT AND STATISTICAL DATA BY FISCAL YEAR. A. DFAS WILL GENERATE AND PROVIDE A MONTHLY FILE OF CIP PAYMENTS TO OTSG AND HRC. HRC WILL SEND DISCREPANCIES TO OTSG. OTSG WILL CROSS CHECK THEIR RECORDS TO ENSURE THAT ALL RECIPIENTS ARE STILL ELIGIBLE FOR CIP. B. DFAS WILL GENERATE AND SEND OUT A MONTHLY STATISTICAL REPORT PROVIDING THE NUMBER OF SOLDIERS RECEIVING CIP. THE REPORT WILL BE BY RANK AND COMPONENT . ADDITIONALY THE MONTHLY COST FOR CIP WILL BE PROVIDED. IF CIP IS RECEIVED FOR A DIFFERENT MONTH THAT MONTH WILL BE IDENTIFIED. 12. RECONSIDERATION ON CIP STATUS. A. SOLDIERS THAT DISAGREE WITH THEIR CIP ENTITLEMENT DUE TO MEDICAL STATUS ARE TO SUBMIT A MEMORANDUM FOR RECONSIDERATION TO: DEPARTMENT OF THE ARMY, OFFICE OF THE SURGEON GENERAL, HEALTH POLICY AND SERVICES, 5109 LEESBURG PIKE, AND FALLS CHURCH, VA 22041-3258. THE OTSG WILL PROVIDE THE SOLDIER WITH THE DECISION ON CIP AFTER CONSIDERING ALL VALID

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INFORMATION. THE MEMORANDUM MUST CONTAIN THE FOLLOWING INFORMATION: (1) PATIENT NAME, SSN, AND CURRENT MTF: (2) MEDICAL STATUS (INPATIENT, OUTPATIENT, EXTENSIVE REHABILITATION): (3) DATE OF HOSPITALIZATION REQUIRING REHABILITATION: (4) DESCRIPTION OF ONGOING EXTENSIVE REHABILITATION: (5) ATTENDING PHYSICIAN POC AND PHONE NUMBER/EMAIL: (6) EXPLANATION OF WHY SOLDIER BELIEVES HE OR SHE MAY BE ENTITLED TO CIP: B. SOLDIERS THAT DISAGREE WITH THEIR CIP ENTITLEMENT DUE TO T-SGLI STATUS ARE TO SUBMIT A MEMORANDUM FOR RECONSIDERATION TO: HUMAN RESOURCES COMMAND, ATTN: AHRC-DZB-TSGLI, 200 STOVALL STREET, ALEXANDRIA, VA, 22332-0470, PHONE: 1-800-237-1336, E-MAIL TSGLI@HOFFMAN.ARMY.MIL OR WEBSITE: WWW.TSGLI.ARMY.MIL. THE TSGLI DIVISION WILL PROVIDE THE SOLDIER WITH THE DECISION ON CIP AFTER CONSIDERING ALL VALID INFORMATION. THE MEMORANDUM MUST CONTAIN THE FOLLOWING INFORMATION: (1) PATIENT NAME, SSN, AND CURRENT MTF: (2) MEDICAL STATUS (INPATIENT, OUTPATIENT, EXTENSIVE REHABILITATION): (3) DATE OF HOSPITALIZATION REQUIRING REHABILITATION: (4) DESCRIPTION OF ONGOING EXTENSIVE REHABILITATION: (5) ATTENDING PHYSICIAN POC AND PHONE NUMBER/EMAIL: (6) EXPLANATION OF WHY SOLDIER BELIEVES HE OR SHE MAY BE ENTITLED TO CIP: 13. DECEASED SOLDIER. UPON DETERMINATION THAT A DECEASED SOLDIER WOULD HAVE BEEN ELIGIBLE TO RECEIVE CIP AS OF 23 MARCH 2006 OR LATER THE OFFICE OF THE SURGEON GENERAL, HEALTH POLICY AND SERVICES DIRECTORATE, DSN 761-3174 OR COMMERCIAL (703) 681-3174 SHOULD BE NOTIFIED. THE OTSG WILL COORDINATE WITH HRC TO DETERMINE IF T-SGLI WAS RECEIVED AND IF SO WHEN. OTSG WILL NOTIFY DFAS OF THE CERTIFYING DATES OF ELIGIBILITY AND STOP DATE. DFAS WILL MAKE THE PAYMENT VIA CHECK OR EFT WITH THE SOLDIER S NEXT OF KIN/LEGAL REPRESENTATIVE. 14. GRIEVANCE. THE ARMY BOARD FOR CORRECTION OF MILITARY RECORDS IS THE HIGHEST LEVEL OF ADMINISTRATIVE REVIEW WITHIN THE DEPARTMENT OF THE ARMY. UNLESS PROCURED BY FRAUD, A DECISION IS FINAL AND BINDING ON ALL ARMY OFFICIALS AND OTHER GOVERNMENT AGENCIES. A. ACTIVE DUTY SOLDIERS AND FORMER MEMBERS OF THE REGULAR ARMY, ARMY RESERVE, AND ARMY NATIONAL GUARD: IF THE FORMER MEMBER IS DECEASED OR INCOMPETENT, THE SURVIVING SPOUSE, NEXT OF KIN, OR A LEGAL REPRESENTATIVE MAY APPLY. HOWEVER, THE

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APPLICATION MUST INCLUDE SUPPORTING DOCUMENTATION SUCH AS A CERTIFIED COPY OF A MARRIAGE LICENSE, DEATH CERTIFICATE, OR POWER OF ATTORNEY AS APPROPRIATE. B. HOW TO APPLY. SUBMIT AN ORIGINAL COMPLETED AND SIGNED DD FORM 149, APPLICATION FOR CORRECTION OF MILITARY RECORD WITH SUPPORTING DOCUMENTATION. BLANK APPLICATIONS FORMS ARE AVAILABLE AT HTTP://ARBA.ARMY.PENTAGON.MIL/ABCMR.HTM BLANK APPLICATION FORMS CAN ALSO BE OBTAINED FROM ANY MILITARY PERSONNEL/ HUMAN RESOURCE OFFICE OR BY SENDING A REQUEST TO THE ARMY REVIEW BOARDS AGENCY, ATTN: CONGRESSIONAL AND SPECIAL ACTIONS OFFICE, 1901 S. BELL STREET, ARLINGTON, VA 22202-4508. YOU MAY ALSO SUBMIT AN APPLICATION ONLINE (HTTP://ACTSONLINE.ARMY.MIL). 15. POINTS OF CONTACT. ENSURE THAT YOU HAVE GONE THROUGH YOUR APPROPRIATE CHAIN OF COMMAND FOR INQUIRIES PRIOR TO HAVING THEM CONTACT THE FOLLOWING POCS: A. THE SURGEON GENERALS OFFICE FOR ELIGIBILITY AND TERMINATION DUE TO MEDICAL STATUS: OFFICE OF THE SURGEON GENERAL, HEALTH POLICY AND SERVICES DIRECTORATE, DSN 761-3174 OR COMMERCIAL (703) 681-3174. B. HUMAN RESOURCES COMMAND FOR T-SGLI AND TERMINATION DUE TO T-SGLI: ATTN: AHRC-DZB-TSGLI, 200 STOVALL STREET, SUITE 8N65, ALEXANDRIA, VA 22332-0470, PHONE #: 1-800-237-1336 OR TSGLI@conus.army.mil, WEBSITE: WWW.TSGLI.ARMY.MIL. C. PAY ISSUES: (1) SERVICING DEFENSE MILITARY PAY OFFICE OR FINANCE OFFICE. (2) USAFINCOM MS. PANSY CHESNEY, PANSY.CHESNEY@DFAS.MIL, DSN 699-2916, (317) 510-2916 OR ALTERNATE MR. JESSE SABLAN, JESSE.SABLAN@DFAS.MIL, DSN 699-6910, (317) 510-6910. (3) DFAS FOR POLICY ISSUES CONTACT MRS. LINDA TWERBERG, LINDA.TWERBERG@DFAS.MIL, DSN 699-3241, (317) 510-3241 OR SYSTEM ISSUES MR. RANDY HARTLE, RANDY.HARTLE@DFAS.MIL, DSN 699-6300, (317) 510-6300. D. COMPENSATION/ENTITLEMENTS, G-1, POC ON POLICY ISSUES CONTAINED IN THIS MESSAGE: MRS. SUSAN DYER, SUSAN.DYER@HQDA.ARMY.MIL, DSN 222-6888, (703) 692-6888. 16. THIS ALARACT APPLIES TO THE TOTAL ARMY. 17. EXPIRATION DATE CANNOT BE DETERMINED. =============================================================== UNCLASSIFIED//

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D-2-8 ALARACT 147/2006 R 031749Z AUG 06 SUBJECT: ANNOUNCEMENT OF THE MEDICAL HOLDOVER (MHO) CONSOLIDATED GUIDANCE 1. THE MHO CONSOLIDATED GUIDANCE COLLECTS ARMY POLICY AND PROCEDURE DOCUMENTS FOR MANAGING RESERVE COMPONENT (RC) ARMY NATIONAL GUARD OF THE UNITED STATES (ARNGUS), AND UNITED STATES ARMY RESERVE (USAR) - MHO SOLDIERS. THIS DOCUMENT STANDARDIZES ARMY GUIDANCE. 2. THE ARMY HAS BEEN HEAVILY ENGAGED IN OPERATIONS IN SUPPORT OF THE GLOBAL WAR ON TERRORISM (GWOT) AS WELL AS OPERATIONS TO MANAGE THE HEALTH, WELFARE, AND READINESS OF SOLDIERS WHO ARE INJURIED OR ILL AS A RESULT OF THE GWOT. PREVIOUSLY, THERE WAS NO OVERARCHING ARMY COLLECTIVE OR REGULATORY GUIDANCE CONSOLIDATING ALL ASPECTS OF MHO OPERATIONS. 3. A MHO SOLDIER IS DEFINED AS AN RC SOLDIER MOBILIZED ON 10 UNITED STATES CODE (USC) 12302 ORDERS FOR CONTINGENCY OPERATIONS IN SUPPORT OF GWOT AND DIVERTED FROM HIS OR HER NORMAL MOBILIZATION MISSION, MEDICALLY EVACUATED (MEDEVAC) FROM THEATER, OR DEMOBILIZATION PROCESSING, WHO IS IN NEED OF MEDICAL EVALUATION AND TREATMENT. 4. THE MHO CONSOLIDATED GUIDANCE CONSISTS OF FIVE CHAPTERS: A. CHAPTER 1. INTRODUCTION. (1) AN OVERVIEW OF THE MHO PROGRAM. (2) AN OVERVIEW OF CHAPTERS 2 THROUGH 5. B. CHAPTER 2. MHO PROGRAM AND MEDICAL RETENTION PROCESSING (MRP). (1) THIS CHAPTER PROVIDES THE IMPLEMENTING INSTRUCTION FOR C2 AND PERSONNEL MANAGEMENT OF RC SOLDIERS WHO MEET MRP CRITERIA AND VOLUNTARILY TRANSITION FROM 10 USC 12302 ORDERS TO 12301(D) ORDERS FOR MRP, TO INCLUDE PARTICIPATION IN THE COMMUNITY-BASED HEALTH CARE INIATIVE (CBHCI). (2) MRP APPLIES ONLY TO RC SOLDIERS CURRENTLY ON ACTIVE DUTY FOR CONTINGENCY OPERATIONS IN SUPPORT OF GWOT. C. CHAPTER 3. MEDICAL RETENTION PROCESSING 2 (MRP2).

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(1) THIS CHAPTER PROVIDES THE IMPLEMENTING INSTRUCTION FOR C2 AND PERSONNEL MANAGEMENT OF RC SOLDIERS WHO MEET MRP2 CRITERIA AND VOLUNTARILY TRANSITION ONTO ACTIVE DUTY (AD) UNDER 10 USC 12301(D) ORDERS FOR MRP, TO INCLUDE PARTICIPATION IN THE CBHCI. (2) MRP2 IS DESIGNED TO AUTHORIZE THE TEMPORARY RETURN TO AD STATUS FOR MRP RC SOLDIERS PREVIOUSLY MOBILIZED IN SUPPORT OF THE GWOT. UNDER MRP2, SOLDIERS MAY VOLUNTARILY RETURN TO ACTIVE DUTY SPECIFICALLY FOR MEDICAL EVALUATION AND TREATMENT FOR INJURY OR ILLNESS INCURRED OR AGGRAVATED DURING THEIR PREVIOUS PERIOD OF MOBILIZATION IN SUPPORT OF THE GWOT. D. CHAPTER 4. ACTIVE DUTY MEDICAL EXTENSION PROCESSING (ADME). (1) THIS CHAPTER PROVIDES THE IMPLEMENTING INSTRUCTIONS FOR C2 AND PERSONNEL MANAGEMENT OF RC SOLDIERS WHO MEET ADME CRITERIA AND VOLUNTARILY TRANSITION ONTO AD UNDER 10 USC 12301(D) ORDERS FOR PARTICIPATING IN ADME. (2) ADME IS NOT PART OF THE MHO PROGRAM. THOUGH SIMILAR TO MRP AND MRP2 THERE ARE SIGNIFICANT DIFFERENCES BETWEEN THE MHO PROGRAM AND ADME. ADME PLACES THE RC SOLDIER ONTO AD IN A MEDICAL HOLD (MH) STATUS. ADME PARTICIPANTS ARE NOT ELIGIBLE FOR THE CBHCI. (3) THE INTENT OF ADME IS TO EVALUATE AND TREAT THE RC SOLDIER WITH A DOCUMENTED IN THE LINE OF DUTY INCURRED OR AGGRAVATED INJURY, ILLNESS, OR DISEASE AND PROVIDE PAY AND BENEFITS, TO THE EXTENT OF THE LAW, TO THOSE SOLDIERS FOR OR RECOVERING FROM THIS SERVICE-CONNECTED MEDICAL CONDITION, AND TO RETURN SOLDIERS BACK TO DUTY WITHIN HIS OR HER RESPECTIVE RC AS SOON AS POSSIBLE. IF RETURN TO DUTY IS NOT POSSIBLE, PROCESS THE SOLDIER THROUGH THE ARMY PDES. THE MEDICAL CONDITION INCURRED OR AGGRAVATED MUST HAVE OCCURRED WHILE IN AN INACTIVE DUTY FOR TRAINING (IDT) OR NON-MOBILIZATION ACTIVE DUTY STATUS AND THAT MEDICAL CARE WILL EXTEND BEYOND 30 DAYS. THE MEDICAL CONDITION MUST PREVENT THE SOLDIER FROM PERFORMING HIS OR HER MILITARY OCCUPATIONAL SKILL / AREA OF CONCENTRATION (MOS / AOC) WITHIN THE CONFINES OF A PHYSICAL PROFILE (DA FORM 3349) ISSUED BY MILITARY MEDICAL AUTHORITY. E. CHAPTER 5. MISCELLANEOUS MHO DOCUMENTS. THIS CHAPTER CONTAINS DOCUMENTS COLLECTED FROM THE VARIOUS AGENCIES

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INVOLVED IN MHO OPERATIONS. DOCUMENTS ARE ORGANIZED BY ISSUING AGENCY. 5. A COPY OF THE WTU (MHO) CONSOLIDATED GUIDANCE IS AVAILABLE AT THE FOLLOWING WEB SITE: HTTP://WWW.ARMYG1.ARMY.MIL/ 6. This document will be periodically updated as the MHO program continues evolving. Therefore, it is recommended individuals do not download this document. 7. THE POINTS OF CONTACT FOR THIS MESSAGE ARE LTC ANNE BAUER OR MSG MICHAEL CARMEL, DIRECTORATE OF MILITARY PERSONNEL MANAGEMENT, ARMY G-1 (DAPE-MPE-DR), DSN: 225-7874/7864, COM: (703) 695-7874/7864. EMAIL: ANNE.BAUER@HQDA.ARMY.MIL OR MICHAEL.CARMEL@HQDA.ARMY.MIL. 6. Expiration date cannot be determined. BT #0115 NNNN

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MILPER MESSAGE NUMBER: 07-206 AHRC-PED

DD FORM 93 UPDATE: NON-MEDICAL ATTENDANT ...Issued: [08/03/2007]...

1. THIS MILPER MESSAGE WILL EXPIRE UPON PUBLICATION OF AR 600-8-1. 2. REFERENCES: A. AR 600-8-1 B. DOD INSTRUCTION 1300.18 (DECEMBER 18, 2000) C. JOINT FEDERAL TRAVEL REGULATION (JFTR) paragraph u7250 and appendix A1 3. ON OCCASION, A SOLDIER’S MEDICAL CONDITION WILL PREVENT THEM FROM COMMUNICATING TO MEDICAL AUTHORITIES THEIR PREFERENCES FOR NON-MEDICAL ATTENDANT AND THE GEOGRAPHIC LOCATION TO RECEIVE MEDICAL CARE. EFFECTIVE IMMEDIATELY, SOLDIERS MAY NOMINATE A NON-MEDICAL ATTENDANT AND IDENTIFY THEIR PREFERRED GEOGRAPHIC LOCATION FOR MEDICAL TREATMENT IN BOX 13 (CONTINUATION/REMARKS) OF THE DD FORM 93, RECORD OF EMERGENCY DATA. 4. WHEN THE NEED ARISES FOR NON-MEDICAL CARE AND ASSISTANCE DURING A SOLDIER’S TREATMENT AT A MEDICAL TREATMENT FACILITY, MEDICAL AUTHORITIES WILL AUTHORIZE A NON-MEDICAL ATTENDANT TO ASSIST THE SOLDIER. MEDICAL AUTHORITIES CONSULT WITH A PAITENT TO DETERMINE THE NON-MEDICAL ATTENDANT ASSIGNED. ADDITIONALLY, MEDICAL AUTHORITIES CONSIDER PAITENT REQUESTS WHEN DETERMINING THE MEDICAL TREATMENT FACILITY WHERE CARE WILL BE PROVIDED AND ATTEMPT TO PROVIDE CARE AS CLOSE TO THE ATTENDANT’S RESIDENCE AS THE MEDICAL SITUATION PERMITS. 5. THE NON-MEDICAL ATTENDANT INFORMATION AND GEOGRAPHIC LOCATION FOR MEDICAL TREATMENT INFORMATION RECORDED IN BOX 13 OF THE DD FORM 93, CONSISTS OF THE FOLLOWING: A. NON-MEDICAL ATTENDANT: NAME, RELATIONSHIP ADDRESS, AND PHONE NUMBER OF THE PERSON THE SOLDIER NOMINATES TO BE THEIR NON-MEDICAL ATTENDANT. B. GEOGRAPHIC LOCATION: CITY AND STATE WHERE THE SOLDIER PREFERS TO RECEIVE MEDICAL CARE. 6. DURING SRP, SOLDIERS SHOULD BE COUNSELED TO FIRST CONSIDER NOMINATING FAMILY MEMBERS WHO ARE MOST LIKELY TO TAKE A PERSONAL INTEREST IN ENSURING THAT THEY RECEIVE QUALITY CARE AND ASSISTANCE. ADDITIONALLY, THE SOLDIER WILL BE ADVISED THAT WHILE EVERY EFFORT WILL BE MADE TO HONOR HIS/HER REQUEST, THERE IS NO ASSURANCE OF THE FOLLOWING: A. PERSON NOMINATED WILL BE THE NON-MEDICAL ATTENDANT. THERE ARE MANY FACTORS THAT MIGHT PRECLUDE THEIR NOMINEE FROM PERFORMING THIS SERVICE SUCH AS THE PERSON NOMINATED MAY NOT BE CAPABLE OF PROVIDING THE PROPER LEVEL OF CARE OR MAY NOT BE AVAILABLE WHEN NEEDED.

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B. MEDICAL CARE WILL BE PROVIDED AT THE GEOGRAPHIC LOCATION DESIRED. MEDICAL AUTHORITIES WILL DETERMINE THE MEDICAL TREATMENT FACILITY WHERE THE BEST POSSIBLE MEDICAL CARE WILL BE PROVIDED BASED UPON, THE MEDICAL TREATMENT PLAN, THE AVAILABILITY OF MEDICAL CARE WITHIN THAT GEOGRAPHIC AREA AND THE LOCATION OF THE NON-MEDICAL ATTENDANT’S RESIDENCE. 7. MEDICAL AUTHORITIES ARE NOT RESTRICTED TO PROVIDING PATIENT CARE IN MILITARY MEDICAL TREATMENT FACILITIES. 8. POC FOR POLICY QUESTIONS IS MR. H. CAMPBELL, DSN 221-7576, CIV 703-325-7576, EMAIL: HAROLD.W.CAMPBELL@CONUS.ARMY.MIL.

Use this URL to link to this document

http://PERSCOMND04.ARMY.MIL/MILPERmsgs.nsf/All+Documents/07-206?OpenDocument

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D-3 OTHER MISCELLENEOUS DOCUMENTS: D-8-1 REQUEST for RELEASE FROM ACTIVE DUTY (REFRAD) _______________________________________ __________________ _______ SOLDIER’S NAME SSN RANK

REASON FFD

NON-COMPLIANCE/ADMIN

WITHDRAWAL

AUTHORITY WTU CONSOLIDATED GUIDANCE

PERSONNEL POLICY GUIDANCE (PPG)

RESERVE COMPONENT PERSONNEL POLICY GUIDANCE

AR 635-200, CHAPTER 4 (ENLISTED)

AR 600-8-24, CHAPTER 2 (OFFICER)

Transitional Leave ______ Days Transition center ____________________ WTU/CBHCO _______________________ ORDER END DATE ________________________

ASSIGNED TO NG ___________________________________________________________

USAR _________________________________________________________

POC _________________________________________________________________________

PHONE ______________________AKO EMAIL ________________________@US.ARMY.MIL

******************************HRC USE ONLY*****************************************

DATE RECEIVED __________________

NO LATER THAN __________________ Soldier is given 14 days from today’s date plus Transitional Leave taken.

REQUIRED DOCUMENTS

FIT FOR DUTY/RETURN TO DUTY STATUS SIGNED BY A MEDICAL PROVIDER

WITHDRAWAL STATEMENT SIGNED BY SM AND COUNSELOR (IF APPLICABLE) Supporting justification documents required for Withdrawal and Non-Compliance. (i.e.

Counseling Statements etc.) Memorandum Optional.

___________________________________________ ______________________ SIGNATURE OF PROCESSOR DATE COMPLETED

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D-3-2 Request Early Release From Active Duty (REFRAD)

DEPARTMENT OF THE ARMY U.S. ARMY HUMAN RESOURCES COMMAND

200 STOVALL STREET ALEXANDRIA VA 22332-0470

OFFICE SYMBOL DATE MEMORANDUM THRU: FOR:

SUBJECT: Request Early Release From Active Duty (REFRAD)

1. A medical evaluation of ___________________________ SSN _____________ has resulted in the following:

( ) Fit For Duty – Released from Active Duty to rejoin unit in CONUS/OCONUS mission. This Soldier meets medical retention standards per AR 40-501 and AR 40-400. The Soldier may need to perform MOS duties within the limits of a physical profile.

( ) Not Fit For Duty – Released from Active Duty. MEB has been adjudicated. Soldier does not meet the medical retention standards per AR 635-40 and AR 600-60. This Soldier needs to follow up with TRICARE, VA, and INCAP upon return to their USAR/NG unit.

( ) Not Fit For Duty – Soldier meets the retention standards per AR 40-501. However, the Soldier is recommended for MOS Medical Retention Board (MMRB). This Soldier needs to follow up with TRICARE, VA, and INCAP upon return to their USAR/NG unit.

2. Soldier Profile: P___U___L___H___E___S___ None___ Temp___ Permanent___ Diagnosis: __________________________________________________ 3. POC for this request is ___________________________________________

____________________________________________ Primary Care Manager Signature date ___________________________________________________________________ Primary Care Manager Name AKO email

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