1. AFRC First Sgt Academy Block II-12
LOD & MEB
AFI , Line of Duty Determination
AFI , Physical Evaluation for Retention,
Retirement, and Separation
AFI , Duty Limiting Conditions
AFI , Patient Administration Functions
AFI , Medical Examinations and Standards
A few times, member’s MEB process was held up significantly when a LOD was found not to be accomplished.
Instances from years back, such as one of my airman needed an LOD for a motorcycle accident he had 2 years prior. They were trying to ensure his injuries were not from his misconduct.
Security Forces member passing out during Wing Change of Command! The shirt overheard someone later say, that is the second time he’s passed out. Actually turned out to a MEB condition.
Oct 2001

2. AFRC First Sgt Academy Block II-12
LOD & MEB
Overview:
Line of Duty (LOD) Definition & Objective
When to Determine LOD
Medical Evaluation Board (MEB) Purpose
MEB Roles and Responsibilities
MEB Process
Actions after IPEB and FPEB
Line of Duty (LOD) Definition & Objective by federal law
LOD Determinations, such as “In the line of Duty” or Existing prior to service
When to Determine LOD.
Medical Evaluation Board (MEB) Purpose
MEB Roles and Responsibilities
MEB Process
Actions after IPEB and FPEB
Oct 2001

3. MP 1: DEFINITION AND OBJECTIVE
AFRC First Sgt Academy Block II-12
MP 1: DEFINITION AND OBJECTIVE
What Is An LOD Determination?
Federal Law requires determination as to whether or not certain injuries or diseases are suffered by military members while in the line of duty (LOD) or as a result of misconduct on the part of the member.
Federal law requires determination as to whether or not certain injuries or diseases are suffered by military members while in a line of duty (LOD) status or whether such injuries or diseases are the result of misconduct on the part of the member.
DEFINITION: An LOD determination is a finding made after an investigation into the circumstances of a member’s illness, injury disease or death. The finding concludes Whether or not the illness, injury, or disease:
(1) existed prior to service (EPTS) and if the an EPTS condition was aggravated by military service,
(2) occurred while the member was absent from duty and
(3) was due to the member’s own misconduct.
Why do you think these agencies need to know LOD determination?
Oct 2001

4. AFRC First Sgt Academy Block II-12
MP 1: DEFINITION AND OBJECTIVE
Protects the government against fraudulent injury claims
Protects the rights of Air Force Airmen who are injured while in the line of duty.
OBJECTIVE:
1. Protects the government against fraudulent injury claims – Use false insurance as example
Protects the rights of AF members who are injured while in the line of duty.
Now that we have fully defined what an LOD is, what would justify an LOD to be started?
Oct 2001

5. MP 2: WHEN DETERMINATIONS ARE REQUIRED
AFRC First Sgt Academy Block II-12
MP 2: WHEN DETERMINATIONS ARE REQUIRED
The death of a member (Admin Determination not Sufficient)
Inability to perform military duties exceeds 24 hours
The likelihood of a permanent disability
When determinations are made:
The death of a member. An administrative determination is not sufficient in a case of death.
The inability to perform military duties exceeds 24 hours.
The likelihood of a permanent disability
Medical treatment of a member of the ANG regardless of the military member’s ability to perform military duties.
( only mention when we go total force) The likelihood of an ANG member applying for incapacitation pay.
A member who has served over 30 days on orders and an illness, injury, disease or death occurred; the member will be retained on orders until the medical condition is resolved.
Incapacitation pay is for injuries under 30 days served is based wage rate for civilian job in relation to the member’s grade, whichever is less.
Oct 2001

6. AFRC First Sgt Academy Block II-12
MP 4: MEB PURPOSE
In order to maintain a fit and vital force, the Secretary of the Air Force relies on disability laws to remove active duty and ARC member who can no longer perform their military duties because of a mental or physical defect. The MEB is the first step in the Air Force disability evaluation process to determine who is not worldwide qualified.
AFI , Patient Administration Functions
PURPOSE: In order to maintain a fit and vital force, the Secretary of the Air Force relies on disability laws to remove active duty and ARC members who can no longer perform their military duties because of a mental or physical defect.
The MEB is the first step in the Air Force disability evaluation process to determine who is not worldwide qualified. AFI , Chapter 5, outlines those medical conditions that require a medical board.
Presumption of Fitness: If a member has performed his or her duty satisfactorily prior to scheduled retirement or an approved separation date, a presumption of fitness is established. This presumption of fitness can be overcome only if clear and convincing evidence to the contrary is established by a preponderance of evidence that on the following exists:
Within the presumption period an acute, grave illness or injury occurs that would prevent the member from performing further duty immediately prior to or concurrent with the processing of normal retirement.
A serious deterioration of a previously diagnosed condition occurs that would occur preventing the member from performing further duty immediately prior to or concurrent with the processing of normal retirement.
There are of course Special Conditions to MEB processing, however we will only discuss three that could come up during your tenure as a First Sergeant.
Members under court martial charges are not eligible for disability processing unless there is a question of mental capacity or responsibility or when member’s sentence of dismissal or punitive discharge is suspended.
Dual-Action cases which are eligible for processing under this instruction and pending involuntary separation or discharge. These cases are processed under both directive, and the Secretary of the Air Force Will make the final disposition.
Members who refuse required professional, medical, dental care, and/or other option of treatment WILL have an MEB if all member was advised clearly and understands not treatment implications and that the member’s refusal is willful or negligent and not the result of mental disease or of physical inability to comply.
Oct 2001

7. AFRC First Sgt Academy Block II-12
MP 5: RESPONSIBILITIES
Medical Treatment Facility Officer
Physical Evaluation Board Liaison Officer (PEBLO)
Commander and Supervisor
Member
Actions Prior to a Medical Evaluation Hearing:
A MTF officer or PCM: has the responsibility to identify service members for MEB whose qualifications for worldwide duty is questionable. They must refer the member for MEB action within 30 days after a complete work-up and a definitive diagnosis has been made.
During the work-up, member must be placed on a 4T profile, meaning member cannot PCS or deploy.
Initiates notification of an MEB action via AF Form 570, notification of patient’s medical status.
Forwards notification to the Physical Evaluation Board Liaison Officer (PEBLO)
PEBLO: Appointed by the MTF Commander, is an experienced, mature individual suitable to handle the important tasks of counseling military members undergoing this complicated process.
The PEBLO:
reviews all the documentation and ensures that a narrative of the condition by the PCM is complete within 30 days of notification of MEB.
Ensures Commander’s impact letter and all necessary documentation is ready for adjudication to HQ AFPC/DPPD or HQ AFPC/DPPAM between 30 and 90 days of narrative completion.
Counsel evaluees concerning their rights in the disability process
Oct 2001

8. AFRC First Sgt Academy Block II-12
MP 6: PROCESSING AN MEB
Member or Primary Care Manager reports condition
AF Form 618 must be processed within in 30 days initiated by Medical Officer
PEBLO facilitates AF Form 469 and briefs member of conditions of MEB and limiting factors
TDY or leave outside local area requires HQ AFPC coord
Commander’s Impact Letter
sample in AFI Attachment 3
IPEB Findings
Member has 10 days to agree or disagree
Stipulations for a Formal Hearing
Disagree with findings
MP 6 PROCESSING AN MEB:
Line of Duty Determination: On AF Form 348 will be completed when misconduct, negligence, or AWOL may have occurred or when a member has a disease or injury which results in an inability to perform military duty for more than 24 hours, or there is the likelihood of permanent disability.
MEBs DO NOT MAKE LOD DETERMINATION. COMPLETED LODs MUST BE INCLUDED AS PART OF AN MEB PACKAGE.
Member either reports condition or found upon medical work up.
Within 30 days of discovery of medical condition, PCM or Medical Officer initiates MEB process on AF Form 618.
Member and unit are notified of MEB establishment via PEBLO and AF Form 469, Profile. Members who are undergoing MEB processing may not be placed on leave outside the local area or TDY without prior coordination with HQ AFPC/DPAMM, except for emergencies.
Commander’s impact letter to the mission due to the PEBLO prior to package meeting the Informal Evaluation Board.
The member must be available to report within one duty day to review the Informal Physical Evaluation Board (IPEB) findings. The member has 10 calendar days to agree or disagree with the IPEB’s findings.
Request a formal hearing if: (1) for any member who disagrees with an unfit finding or (2) member disagrees with a FIT finding (sufficient justification must exist).
Member is authorized 3 duty days after arrival at the hearing to review the available records and prepare the case. Military legal counsel will be provided.
TRANSITION: Whenever a member has a physical limitation or diagnosis that may affect their retainability for continued military service or mobility status which is not likely to resolve within twelve months, the member will have an MEB or ALC-R
Oct 2001

9. AFRC First Sgt Academy Block II-12
MP 7: POST IPEB AND FPEB
Base findings on the facts and circumstances in each case
Relationship between disability and required military duty
Findings in favor of member unless preponderance of evidence dictates otherwise
Return to Duty
Permanent Retirement
Temporary Retirement
Discharge with Severance Pay
After the PEB has made a final decision, The PEB bases these findings on the facts and circumstances in each case. There must be some definite causal relationship between the disability and the required military duty. Resolve findings in favor of the member unless the preponderance of the evidence dictates otherwise.
Return to Duty. Applies to all members found physically fit, except TDRL members or previously retired members on active duty.
Permanent Retirement.
Temporary Retirement. Use of the TDRL. When the PEB finds a disability may be permanent in character, but not stable in degree, and the member otherwise qualifies for disability retirement, the Air Force places the member on the TDRL. The TDRL is a way to further observe unfit members whose disability has not stabilized and for whom the PEB cannot accurately assess the degree of severity, percent of disability, or ultimate disposition. The TDRL also serves as a safeguard for both the member and the Air Force by delaying permanent disposition for those members whose conditions could improve or get worse, or where the ultimate disposition could change within a reasonable period of time.
Discharge With Severance Pay.
Discharge Under Other Than 10 U.S.C. Chapter 61. Add "(EPTS)," "(Excess Leave)," or "(Not Proximate Result)," to more fully explain this disposition action.
Discharge Under 10 U.S.C Use only when the member is unfit and the disability is due to intentional misconduct, willful neglect, or was incurred during a period of unauthorized absence.
Removal From TDRL (Fit). Use only for TDRL members found fit and being removed from the TDRL.
Retain on TDRL. Use only for unfit TDRL members retained on that list.
Revert With Disability Benefits: Except as shown below, use this recommended disposition for an unfit retired member serving on AD who is reverting to the retired list with disability benefits. Under this category, add "Temporary Retirement" or "Permanent Retirement," as applicable, in item 12 of AF Form 356. Example: "Revert with Disability Benefits (Temporary Retirement)." EXCEPTION: To receive disability benefits, unfit members previously retired for years of service or age must have a disability of 30 percent or more (10 U.S.C (b) and 1402(a)). Otherwise, the member reverts to the retired list without disability benefits.
Revert Without Disability Benefits. Use only for a retired member serving on AD who is reverting to the retired list without disability benefits.
Oct 2001

10. ASSIGNMENT LIMITATION CODES (ALC)
AFRC First Sgt Academy Block II-12
MP 7: POST IPEB AND FPEB
ASSIGNMENT LIMITATION CODES (ALC)
ALC-C1: Deployable/Assignable to Global DoD fixed installations with intrinsic Medical Treatment Facilities
ALC-C2: Deployable/Assignable to CONUS installations with intrinsic fixed Medical Treatment Facility
ALC-C3: Non-Deployable/Assignment limited to specific CONUS installations based on medical need.
AFPC/DPAMM may assign the following ALC-C codes based on risk and
medical requirement. The code will be valid indefinitely, but should be reviewed and
renewed at least annually. The risk period for consideration will be one year.
ALC-C1 Deployable/Assignable to Global DoD fixed installations with
intrinsic Medical Treatment Facilities (MTF). This code will be used primarily to
identify individuals with temporary or mild conditions requiring medical follow-up
but whose condition is clinically quiescent or unlikely to cause serious impact if
untreated or treatment is limited to primary care during periods of deployment or
assignment.
 REVIEW in LIEU OF (RILO) annual basis
ALC-C2 Deployable/Assignable to CONUS installations with intrinsic
fixed MTFs (Tricare Network availability assumed). This ALC-C will be used for
medical conditions for which specialist medical care and referral within one year is
likely but who could be deployed or reassigned OCONUS or to non-fixed
environments if appropriate specialty care is available, or for short periods of time.
ALC-C3 Non-Deployable/Assignment limited to specific CONUS
installations based on medical need. This ALC-C stratification designates members
who should not be deployed or assigned away from specialty medical capability
required to manage their unique medical condition.
Oct 2001
12-10

11. AFRC First Sgt Academy Block II-12
Summary
Line of Duty (LOD) Objective
When to Determine LOD
Medical Evaluation Board (MEB) Purpose
MEB Roles and Responsibilities
MEB Process
Actions after IPEB and FPEB
Summary
Then remember that Security Forces guy? Well he had an acute blood disorder coupled with (Leukepenia)
Oct 2001

12. QUESTIONS? First Sergeant Academy Integrity – Service – Excellence
Our Job Is People, Everyone is our Business
Integrity – Service – Excellence
QUESTIONS?