Medical Overview

1. Medical Overview LTC Canoll 63 RRC COMMANDS SURGEONS OFFICE

2. AGENDA • Role of the Command Surgeons Office • DA Form 7349 • Review of profiling • LOD / INCAP • Review of Benefits • Transformation Update • AELNO WFAC Update

3. Surg Office Mission Statement To ensure that all units in the command are in a constant state of medical and dental readiness and that training is performed with ample medical support as prescribed by regulations.  It is the Surgeon's responsibility to provide medical advice to the commander concerning soldier readiness, health care entitlements and medical plans and operations. The surgeon's office monitors medical unit readiness indicators,  mission-essential task list (METL) training, force structure, unit stationing and medical logistics issues. In the area of medical readiness support, the Surgeon serves as a liaison with the USARC Surgeon, MEDCOM and ARMEDCOM. This office provides information on health care entitlement programs, medical disaster/emergency planning that includes weapons of mass destruction and antiterrorism for force protection, staff assistance visits to command supported units, and provides oversight and guidance on medical and dental soldier readiness processing. The Surgeons' Office ensures that physical examinations are conducted according to regulations, performs audits of medical and dental records and monitors soldier medical profiles.

4. Where we can help you • Medical Readiness • Mobilization / Demobilization assistance • MRP2 / ADME processing • Coordination with VA / Tricare / RHRP • Incapacitation Pay • Assistance with Benefits • Board Processing • Medical planning • Professional Development

5. DA Form 7349 • Form used as a validation of Soldiers deployability • Signed off by physician after review by AN • Can lead to profiling / board process • It is based on self assessment, will be one tools used in the PHA process • Standard is to have 7349 with in 3 months of deploying.

6. Profiling DA form 3349, the Army profiling system is a standardized way of documenting soldiers’ physical limitations in relation to duty. This is one of the three most critical documents in regards to medical readiness. A profile is the key to medical board actions, and limitations to duty. The parts affected and the functions involved are: P - Physical capacity or stamina. U - Upper extremities. L - Lower extremities. H - Hearing and ears. E - Eyes. S - Psychiatric.

7. Profiling cont Four numerical designations are assigned for evaluating the individual’s capacity: 1 - Possesses a high level of medical fitness. 2 - An individual possesses some medical condition or physical defect which may impose some limitations on classification and assignment. 3 - The individual has one or more medical conditions or physical defects that requires certain assignment restrictions. The individual should receive assignments commensurate with his/her physical capability for military duty. 4 - The individual has one or more medical conditions or physical defects of such severity that performance of military duty must be drastically limited.

8. Profiling cont A profile is written on a DA Form 3349. The two types of profiles are temporary or permanent. A temporary profile is a condition that is correctible or treatable. It can be up to 90 days in length and a soldier can receive 4 consecutive temporary profiles before further action must be taken. Temporary profiles can be signed off by one profiling officer

9. Profiling cont • A permanent profile includes a medical condition or permanent physical defect which is not expected to change. A permanent profile requires two profiling officer signatures, one of which will be the Command Surgeon. • Units will directly coordinate with a local ARMEDCOM unit to set up an appointment.

10. Profiling / Board Actions at Unit • Need to assist the Soldier in preparing the packet. • Need to be specific with timeframes and put in writing, counsel the Soldiers on the actions they are expected to perform in relation to their packet. • Unit commanders sign the profile take the opportunity at that time to work and counsel Soldier

11. LOD Line of Duty, DA form 2173, is the second of three most important forms within medical readiness. A line of duty is used for Soldiers that get injured while performing military duty. While this action is HHC and G1-centric, it is imperative to this office as it impacts on incapacitation pay, further medical treatment, MMSO payments and military fitness. LOD processing schematic is attached.

13. INCAP

14. Common Errors Board Packets • Commander’s letter not specific to retain or not retain • Lack of current medical information • Current 7349 • Packets submitted for Soldiers within 12 months of ETS / MRD or retirement • Not using the checklists provided, lack of attention to detail and hand jammed corrections

15. Myth vs Fact • Soldiers will leave theater with LOD • Soldiers will be “taken care of” when REFRAD • Soldiers are entitled to having specialty care diagnostics in support of board.

16. Army Physical Disability Evaluation System (PDES) Physical Evaluation Board Transition Medical Evaluation Board Medical Treatment & Care Comprehensive Physical Return To Army Return To Army Complete PEB Retire for Disability Return to Duty Profile Transition point Refer To MEB W/Wo Severance pay YES Veterans Administration Return To Army Soldier review/ appeal NO In/Out Patient Medical Care Transition/ Retirement Services Complete MEB Soldier Review/ appeal Formal Board Informal Board Seamless Transition Evacuation Refer To PEB Receive MEB Injured in CONUS Injured in Theatre 90 days 40 days 30 days 1- 365 days Processing Time (Goals)- Actual Days Generally Exceed 500 Days

17. Optimal Care Achieved Elements of the Physical Disability Evaluation System MEDCOM Actions (PEBLO) Counseling (Army attorney) Color Key PERSCOM Actions MEB (MTF) PEB (PDA) Transition (HRC) Installation Actions Physician Phase Rehabilitation Phase Temp Profile Perm Profile 14 days to complete exams Surgery, PT, trial of duty, etc. NARSUM Phase R Rehab T Complete D PEBLO Phase PDB message via TRANSPROC, PEB/PDA Review M Consults Or Physician issues P3 / P4 Installation receives, cuts orders Physician/ E Soldier Appt CCEP Workup B Review Final Out Meets medical retention Soldier has 72 hrs to appeal to DCCS clinical data Formal/Informal Standards - No Transition Out Appeal Dictates Meets medical retention Labs Board - Transitional leave Standards - Yes (DODI 1332.38 (DODI 1332.38 M - PTDY sets standard) sets standard) Re-class, 6 mos M - Clearing time probation status, R 30 days 40 days 30-90 days Retain, MEB B Dictation PEBLO 60 days to conduct Unit & Transition Pt Findings Determined assemble case, MMRB coordinate separation mail to PEB date

18. Review of Benefits • Premob • 90 days out from MOB Tricare • RHRP Dental Treatment • Postmob • 180 days TAMP • 5 yrs VA, encourge Soldiers to take advantge • TRS / Concordia

19. North Dakota Montana Washington Maine South Dakota Minnesota VT Wyoming NH Wisconsin MA Oregon RI CT Michigan Idaho New York Colorado Pennsylvania Utah Iowa Ohio Nebraska MD Indiana Illinois DE DC WestVirginia Kansas Missouri Virginia Nevada Kentucky North Carolina California Tennessee South Carolina Oklahoma Arizona Arkansas New Mexico Georgia Mississippi Alabama Texas Louisiana Florida Regional Support Commands 88th RSCFt McCoy, WI Establish: 16 Sep 08BOD: 17 Sep 08 Construction Status 64% 99th RSCFt Dix, NJ Establish: 16 Sep 08BOD: 19 Sep 08 Construction Status 65% 81st RSCFt Jackson, SC 63rd RSCMoffett Field, CA Establish: 16 Sep 08BOD: 25 Mar 08 Construction Status Establish: 16 Sep 08BOD: TBD Construction Status 88% 0% BOD: Building Occupancy Date

20. 103d ESC 200 MP CMD 316th ESC 416 ENCOM AR TSD-E MIRC 310th ESC 80th Tng Cmd (TASS) 11 AC (T) AR TSD-W USACAPOC 84th Tng Cmd (Ldr Readiness) 108th Tng Cmd (IET) 311th ESC AR SPT CMD 335 SC (T) USARRC 412 ENCOM 143d ESC 311 SC (T) 807th MDSC 377 TSC (Main) 377 TSC (Main) 75th Div (BCST) Operational Commands Functional Commands Operational & Functional Commands 3d MDSC

21. To be considered an AW2 Soldier, a Soldier must: • Suffer from injuries or illness incurred after 10 September 2001 in support of the Global War On Terrorism • Receive or expected to receive a 30% rating for one or more injuries rated by the Physical Disability Evaluation system in categories such as: • Loss of Vision/Blindness • Loss of Limb • Spinal Cord Injury/Paralysis • Permanent disfigurement • Severe burns • Traumatic Brain Injury • Post Traumatic Stress Disorder • Fatal / Incurable Disease • Any other condition requiring extensive hospitalizations or multiple surgeries

22. Health Care TRICARE VA Health Care Medicare/Medicaid Retirement & Disability Compensation U.S. Army Retirement Pay VA Disability Compensation TSGLI CRSC SSI Disability Compensation Transition Assistance Army Career and Alumni Program (ACAP) VA Disabled Transition Assistance Program (DTAP) VA Seamless Transition Unemployment Compensation VA Adaptive Housing & Vehicle Assistance $10,000 and $50,000 grants for housing adaptation $11,000 toward automobile Adaptive equipment, repair, replacement or reinstallation VA Education & Training Montgomery GI Bill (MGIB) VA Educational Assistance to spouses and children of permanently and totally disabled veterans VA Vocational Rehabilitation & Employment Evaluation of talents, skills and interests Resume and work readiness assistance Help finding and keeping a job Vocational counseling and planning On-the-job training and work-experience programs Training – Certificate, two, or four-year college or technical programs Supportive rehabilitation services and counseling Department of Labor (DOL) REALifelines Disabled Veterans Outreach Program Specialists (DVOP) Local Veterans Employment Representative (LVER) AW2 Links Soldiers and Family Members to Valuable Federal Benefits

23. WFAC The AR - Warrior and Family Assistance Center provides the Army Reserve Soldiers, Families and Units a single source for the resolution of situations related to medical issues and education on programs available to AR Soldiers. Our ultimate goal is to empower and educate the Soldier’s first level supervisor toward conflict resolution and chaos reduction.

24. AR- Warrior and Family Assistance Center Connecting Army Reserve Soldiers and Families to Available Benefits • Infrastructure that fully supports the present needs of the Reserve Soldiers and Families and anticipates the evolving needs of the Future Force. • Recurring, up-to-date, easily accessible Common Operating Picture of Reserve Soldier Entitlements. • Responsive, flexible, and adaptable support to the Warfighter, their families and units. ENDS • Partner across Federal, State and Private Resources to obtain the resources to support the needs of an All Volunteer Reserve Force engaged in a protracted fight. • Achieve a shared “common operating picture” of resources, functions, and entitlements in order to find efficiencies and reduce confusion for the Soldier. • Execute AR programs for the Wounded Warrior Hotline, Sponsor Program and other well-being, personnel and medical programs. • Provide a standard level of service to all Soldiers & Family • members to ensure their physical, mental and spiritual well-being through referral to robust support systems coupled with timely and professional follow-up. WAYS • Resolve Issues • Validate “good ideas” • Continuously update information • Distribute Information MEANS • Educate • Extinguish Chaos • Resolve Issues Priorities:

25. The Army Reserve – Training Soldiers and Growing Leaders ARRC-WF Home Locations, by State, of AR Soldiers Assigned to Warrior Transition Units (WTUs) as of 3 Oct 07 PR 38

26. 3 5 1 4 4 3 1 5 2 2 AR-Wounded Warrior Sponsorship Program Lifecycle AR Soldier Transition Through Medical Support System Evac & Notification Treatment Evaluation Follow-on Support Rehabilitation RTD Separate/Retire AR-WFAC Coordinator assigns a Sponsor Needs assessment, home UIC contact, local Sponsor assigned, work plan established Contact WTU leadership for offer of support, family outreach and connection to AR-Family Programs update home UIC, follow up work plan Assist Family with needs, if local engage Local Sponsor to assist w/County, State or NGO support, rpt to home UIC follow up work plan Assist Family with needs, engage Chaplain, Family Programs, Local Sponsor. If separated assist w/VA, Social Security, Employment encourage home UIC to never forget Yearly follow-up call, engage VA Center, Family Programs, Local Sponsor if necessary. AR –WFAC Sponsor Commitments

27. AR WFAC Sponsor Peer & Advocate Proactive, Compassionate, Whatever-it-Takes! Portal through which flows information, education, empowerment and augmentation of and about: RRC/RRSC Staff Veterans Service Organizations WTU Staff Army Wounded Warrior Program AER FRG State Agencies Legal Faith-based Initiatives Soldier Support Staff IMCOM USO Home Unit Federal Agencies Faith-based organizations Family Programs USARC Staff Military Once Source HRC St. Louis TRICARE County Agencies Grass-Roots Organizations NGB Chain of Command HRC Alexandria Joint Community Education Non-Governmental Organizations