The Stress Continuum Model
Physical or mental health problems that are expected to render a member unable to fully perform his/her duties, exceeding 90 days require a Medical Evaluation Board (MEB). A Limited Duty Board is a type of MEB that places a member in a less than full duty status for 6 months. If a Sailor has a condition that is incompatible with military duty or that results in disqualification from world-wide deployment for more than 12 months, he/she will be referred to a Physical Evaluation Board (PEB). Medical boards are initiated by the Military Treatment Facility and no action is required by the member's command. However if the MEB refers the case to a PEB, the member's command must complete a Non-medical Assessment for the PEB to be processed. Examples of mental health conditions requiring a MEB include psychotic disorders or major depression that is unresponsive to treatment. A Limited Duty Board consists of two active duty physicians and a convening authority who review the clinical case and at the completion of the period of limited duty and decide whether the individual should be returned to full duty or, be referred to a Physical Evaluation Board (PEB).
The PEB, provides a formal fitness-for-duty and disability determination that may return the Sailor to duty (with or without assignment limitations), place the member on the temporary disabled/retired list, separate the Sailor from active duty, or medically retire the member. These recommendations are forwarded to a central medical board and can be appealed by the Sailor, who is permitted to have legal counsel at these hearings.
When faced with a MEB some Sailors may feel apprehensive, angry, or even "abandoned" by the system. Individuals being evaluated for psychological problems may be especially vulnerable to depression or anxiety and sometimes may experience thoughts of harm to self or others.
Awaiting the results of an MEB/PEB can be stressful. It is important for leaders to check in periodically with Sailors awaiting board results and make appropriate support services. Members should be given every reasonable opportunity to fully participate in unit activities according to their physical and psychological health status. It is also important that individuals follow-up with scheduled appointments.
The policy on MEBs and PEBs is found in: SECNAVINST 1850.4 and NAVMED..
Chozinski, J.P., & Bourgeois, J.A. (2001). Psychiatric profiles in the U.S. Air Force: A clinical interpretation of Air Force Instruction 48-123. Military Medicine, 166, 112-115.
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