Mission

2. 2 Soldiers mobilized under 10 USC 12302 partial orders who found medically non-deployable will be REFRAD within the first 30 days. The Soldier will be returned to their unit of assignment and HOR. The unit of assignment will responsible initiating the board action within the Chain of Command for their Soldier.Soldiers mobilized under 10 USC 12302 partial orders who found medically non-deployable will be REFRAD within the first 30 days. The Soldier will be returned to their unit of assignment and HOR. The unit of assignment will responsible initiating the board action within the Chain of Command for their Soldier.

3. 3 WARRIOR IN TRANSITION UNIT Warrior In Transition Unit (WTU): The bridging strategy the Army will pursue is the merging of existing medical hold companies and detachments with Medical Retention Processing Units (MRPUs). The WTU will be multi component units. Soldiers currently assigned to these units as cadre or Warriors in Transition will remain assigned. (ALARACT 135/2007) Warrior In Transition Unit (WTU) Soldiers: A WTU RC Soldier is defined as a Reserve Component (RC) Soldier mobilized on 10 United States Code (USC) 12302 orders in support of contingency operations and diverted from his/her normal mobilization mission, 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 active duty (AD) status in support of the Global War on Terrorism (GWOT). (WTU Consolidated Guidance) Warrior In Transition Unit (WTU) Warrior In Transition Unit (WTU)

5. 5 MRP Purpose/Intent: The MRP program is designed to compassionately evaluate and treat the RC WT with an �in the line of duty� incurred illness, injury, disease or an aggravated pre-existing medical condition. To, as soon as possible, return Soldiers back to duty within their respective RC. If a return to duty is not possible, process the WT through the Army Physical Disability Evaluation System (PDES). The MRP program is designed to compassionately evaluate and treat the RC WT with an �in the line of duty� incurred illness, injury, disease or an aggravated pre-existing medical condition. To, as soon as possible, return Soldiers back to duty within their respective RC. If a return to duty is not possible, process the WT through the Army Physical Disability Evaluation System (PDES). The MRP program is designed to compassionately evaluate and treat the RC WT with an �in the line of duty� incurred illness, injury, disease or an aggravated pre-existing medical condition. To, as soon as possible, return Soldiers back to duty within their respective RC. If a return to duty is not possible, process the WT through the Army Physical Disability Evaluation System (PDES).

6. 6 MRP Eligibility Criterion: This program applies only to RC Soldiers currently on active duty for contingency operations in support of the Global War on Terrorism (GWOT). Soldiers who voluntarily transition from 10 USC 12302 partial mobilization orders to 10 USC 12301(h) orders for MRP, to include participation in the Community Based Health Care Organization (CBHCO). Soldier must have incurred an illness, injury, or disease, or aggravated a pre-existing medical condition in the line of duty. The RC Soldier MUST be on a GWOT order The Soldier MUST volunteer/request the MRP order The medical condition MUST be in the line of duty The RC Soldier MUST be on a GWOT order The Soldier MUST volunteer/request the MRP order The medical condition MUST be in the line of duty

7. 7 MRP Eligibility Criterion Con�t: Military medical authority must determine a Soldier is not expected to RTD within 60 days from the time he or 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 date left on 10 USC 12302 partial mobilization order, then the Soldier will be converted from partial mobilization orders to MRP 12301(h) orders, subject to the Soldier�s consent. 5. In emergent situation and Soldier is unable to consciously make the decision to request or decline MRP, the legal next of kin has the authority to decide for the Soldier. If there is no legal next of kin, the unit commander will treat this case as an emergent case and request MRP orders on the Soldier�s behalf. (WTU Guidance, Chapter 2; para 3 (a) � (e); pg 19). 4. Point out 60 to 120 day rule 5. In emergent situations where the Soldier cannot make a conscious decision for the MRP program, the legal next of kin has the authority. In case there is no legal next of kin the unit Commander will request the MRP order.4. Point out 60 to 120 day rule 5. In emergent situations where the Soldier cannot make a conscious decision for the MRP program, the legal next of kin has the authority. In case there is no legal next of kin the unit Commander will request the MRP order.

8. 8 MRP Disqualifications Soldier discharged or separated from the Army. Active Component / Title 10 (USAR AGR). Pregnancy will not be a criterion for entry. Pending UCMJ. Pre-existing condition not aggravated during current call to duty. Expired ETS (Soldier must supply a DA form 4836, if ETS is about to expire). Soldiers Mobilization on other than 10 USC 12302 orders. (WTU Guidance, Chap. 2, para 4 (a) � (i); pg 19-20.)

9. 9 MRP MRP orders are published in 179 day increments. Special Categories: 358 days automatically Traumatic Brain Injuries Spinal Cord Injuries Burn patients Major Post Traumatic Stress Disorder (PTSD) Amputee

10. 10 MRP Team SFC Sealey, Georgeta Phone: (703) 325-4575 Email: georgeta.sealey@conus.army.mil SGT Jordan, Trent Phone: (703) 325-1865 Email: trent.jordan@conus.army.mil

12. 12 MRP2 Purpose/Intent: The MRP2 program is designed to voluntarily return Soldiers back to temporary active duty, to evaluate or treat RC WT with unresolved mobilization connected medical condition that either was not identified or did not reach optimal medical benefit prior to their REFRAD. Eligibility Criterion: 1. RC Soldiers mobilized in support of a contingency operation may apply for MRP2 within six months from their date of REFRAD. 2. Soldier must be medically approved by the MRP2 Medical Review Board to enter the MRP2 program. (WTU Guidance, Chapter 2, para 5, p 20). A Soldier mobilized on a GWOT has up to six months to request to be placed in the MRP2 program. There MUST be an approved LOD for the medical condition. 2) The MRP2 Medical Review Board MUST approved this processA Soldier mobilized on a GWOT has up to six months to request to be placed in the MRP2 program. There MUST be an approved LOD for the medical condition. 2) The MRP2 Medical Review Board MUST approved this process

13. 13 MRP 2 Disqualifications Soldiers discharged or separated from the Army. Soldiers in the Active Guard Reserve (AGR). Pregnancy will not be a criterion for entry into the program. Pre-existing Medical Conditions; Soldiers with a pre-exiting medical condition not aggravated while on active duty. In Line of Duty (LOD)-No Determinations. Soldiers in an approved Continuance on Active Duty Reserve (COAR) status. (Ref: WTU Guidance Chapter 2, para 6; (a) - (f), pg 20).

14. 14 MRP 2 � Approval / Denial Approved packets are sent to the Regional Case Manager for assignment. ( 5 days for placement) Distribution of MRP 2 order: Unit POC, Regional Case Manager, gaining command (C2), finance, and Soldier via AKO account. Denied packets are sent a denial memo to the POC with explanation from the board. The Soldier can appeal the decision by providing memorandum explaining justification for appeal and/or any necessary documentation.

15. 15 MRP 2 Team SGT Dickinson, Steven Phone: (703) 325-6702 Email: steven.dickinson@conus.army.mil

17. 17 Purpose/Intent: The ADME program is designed to voluntarily place Soldiers on temporary active duty, to evaluate or treat RC WT with in-the-line-of-duty service connected medical conditions or injuries. 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. ADME

18. 18 ADME Intent: To evaluate and treat the RC Soldier with a documented in the line of duty incurred or aggravated injury, illness, or disease. Additionally, to provide pay and allowances, to the extent permitted by law, to those Soldiers while being treated or recovering from this Service-connected medical condition. Ultimately, the goal is to return Soldiers back to duty within his or his respective RC as soon as possible. If return to duty is not possible, process the Soldier through the Army PDES.

19. 19 ADME Eligibility Criterion: RC Soldier that incurred or aggravated a medical condition while in an Individual Duty for Training (IDT) or non-mobilization active duty status. Medical care will extend beyond 30 days. 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. Soldier must be medically approved by the ADME Medical Review Board to enter the ADME program. (WTU Admin Guidance, Chap. 2, para 7 (a) � (d) pg 20). Inactive duty for training, ASDW (ADOWS) or Annual Training orders Medical MUST extend beyond 30 days The medical condition MUST prevent the Soldier for performing his/her MOS The ADME Medical Review Board MUST approved this process Inactive duty for training, ASDW (ADOWS) or Annual Training orders Medical MUST extend beyond 30 days The medical condition MUST prevent the Soldier for performing his/her MOS The ADME Medical Review Board MUST approved this process

20. 20 ADME Disqualifications Soldiers discharged or separated from the Army. Soldiers in the Active Guard Reserve (AGR). Pregnancy will not be a criterion for entry. Pre-existing Medical Conditions; Soldiers with a pre-exiting medical condition not aggravated while on active duty. In Line of Duty (LOD)-No Determinations. Medical treatment is less than 30 days. (WTU Guidance Chapter 2, para 8(a) - (i), pg 21). There MUST be an approved line of duty for the medical conditionThere MUST be an approved line of duty for the medical condition

21. 21 ADME � Approval / Denial Approved packets are sent to the Regional Case Manager for assignment. (5 days for placement) Distribution of ADME orders: Unit POC, Regional Case Manager, gaining command (C2), finance, and Soldier via AKO account. Denied packets are sent a denial memo to the POC with explanation from the board. The Soldier can appeal the decision by providing memorandum explaining justification for appeal and/or any necessary documentation.

22. 22 ADME Team SFC Ellerbe, Mi�Nell Phone: (703) 325-9071 Email: minell.ellerbe@conus.army.mil SFC Williams, Camella Phone: (703) 325-9095 Email: camella.williams@conus.army.mil

23. 23 General Information HRC-A is the only office authorized to generate orders for ADME, MRP and MRP2 programs. All request for extensions must be submitted NLT 45 days prior to expiration date of current order, unless Soldier has pending doctors appointments. Extensions beyond 358 days require approval by the MTF Deputy Chief of Clinical Services (DCCS). Administrative Actions do not hinder a Soldier from receiving medical care. Note: All orders are published in increments of 179, 358, and 537 days. Orders are not utilized to replace lost time and wages. The start date on all orders will be the date a COMPLETE APPLICATION is received by HRC-A (back dating of orders is not authorized).

24. 24 General Information Con�t 1. Unit Administrators/Commanders should submit an informational application to Regional Readiness Command (RRC) or State National Guard Bureau. The application should be submitted to Human Resources Command-Alexandria (HRC-A) 2. All applications received IAW checklist are processed and sent to the Medical Review Board (MRB) within 3 business days. Incomplete applications will be returned without action with suspense date not to exceed 14 business days from date of memorandum. The MRB makes an approval/denial determination within 10 business days of receipt of complete application. If additional documentation is requested by the MRB the application is not complete until received.

25. 25 General Information Con�t 4. Resubmission of an application: consists of providing HRC-A with additional documentation requested to support previous submission of application (WTU Guidance CH 3, para 16(c), 1-7, pg 38-39; Encl B-17 pg 109). 5. Appeal of an application: consists of application denial and request for further examination by higher approval authority without including additional documentation. Higher approval authority for medical - Office of the Surgeon General (OTSG) Higher approval authority for administrative - Headquarters of the Department of the Army G-1 (HQDA G-1). (WTU Guidance CH 3, para 16(d), 1-5(f), pg 39; Encl B-17 pg 109). Exception to Policy: For purposes of documentation, the WTU-Consolidated Guidance defines �EXCEPTION� as a request by the Soldier to waive a rule or policy statement based on mitigating or exceptional circumstances. (WTU Guidance CH 3, para 16(b), 1-3, pg 38; Encl B-17 pg 109). Exception to Policy: For purposes of documentation, the WTU-Consolidated Guidance defines �EXCEPTION� as a request by the Soldier to waive a rule or policy statement based on mitigating or exceptional circumstances. (WTU Guidance CH 3, para 16(b), 1-3, pg 38; Encl B-17 pg 109).

27. 27 REFRAD HRC-A, Mobilization Support Branch, Medical Section is the �ONLY� authority to approve or deny MRP REFRAD requests.

28. 28 REFRAD TYPES 1. Fit For Duty (FFD) / Return to Duty (RTD) 2. UNFIT 3. NON-COMPLIANCE (Admin/UCMJ) 4. WITHDRAWAL

29. 29 Fit For Duty/Return To Duty(FFD/RTD) MHO Soldier�s found FFD/RTD. Warrior Transition Unit (WTU) submits provider documentation, HRC checklist and DA Form 4187. No Later Than date (NLT) comprised of 14 days for out-processing, Transitional Leave plus PDMRA (PPG pg 184, ALARACT MSG 173-2007) if applicable. 4. HRC-A verifies packet and sends REFRAD memo to the following agencies: WTU/CBHCO of origin. Transition Center. Army National Guard (ARNG) or Regional Readiness Command (RRC). Military Pay.

30. 30 UNFIT REFRAD Upon completion of the Physical Disability Evaluation System (PDES), UNFIT Packet sent to HRC-A from Walter Reed Physical Disability Agency (PDA). 2. UNFIT REFRADs receive 30 day NLT date. 3. Transitional Leave is authorized. 4. Temporary/Permanent Disability Retirement List (TDRL/PDRL) 90 days NLT in TRANSPROC.

31. 31 Non-Compliance Not attending doctors appointments or formations. 2. Consistently changing medical appointments w/out proper authority (manipulation of Chain of Command). 1. Supporting justification documents required (i.e. Counseling Statements, etc.). 2. Memorandum from the Commander is optional.

32. 32 Withdrawal 1. Requests to withdraw from MRP/MRP2/ ADME during the first 179 days will be denied, except for extreme circumstances. 2. Supporting justification documents. 3. Declination or MRP Withdrawal Statement. (WTU Guidance, Chapter 3; Encl B-16; pg 108) 4. Memorandum from the Commander is optional.

33. 33 REFRAD Process

34. 34 CLOSING RECORDS The POC is required to forward the DD 214 and release orders to HRC-A. 2. If no DD 214 or release order is received or available in TRANSPROC, the WTU will be contacted to verify the status of the Soldier. 3. HRC-A will rescind the unexecuted portion of the MRP, MRP2 and ADME order and submit it to finance.

35. 35 Process for Revocation of REFRAD Memo The following documentation must be submitted to HRC-A Medical Section: 1. Medical documentation annotating the Soldier is no longer medically fit/return to duty (handled on a case by case basis). 2. Memorandum of Justification (supporting documentation; if applicable).

36. 36 MRP Soldiers requesting Sanctuary 1. REFRAD process must be initiated when Soldiers are found Fit for Duty. 2. Inform REFRAD section of pending application for Sanctuary program (Title 10 USC, 12686a). 3. Upon Sanctuary approval, orders will be generated based on the REFRAD date of the Soldier; Soldier will not incur a Break in Service.

37. 37 REFRAD Team SFC Michelle McDonald, Transitions/REFRADs Phone: (703) 325-9072 Email: michelle.mcdonald@conus.army.mil SGT Leola Townsend, REFRADs Phone: (703) 325-6708 Email: leola.townsend@conus.army.mil SPC Carey Tanks, REFRADs Phone: (703) 325-1864 Email: carey.tanks@conus.army.mil

38. 38 Future Outlook Currently Army G1, OTSG, HRC-A and other Medical Agencies have initiated a Test Pilot Program regarding transferring Active Duty Component (COMPO 1) from WTU to CBHCO.

39. 39 Policy Guidance Websites

40. 40 Additional Information Military Medical Support Office (MMSO) http://www.mmso.med.navy.mil or 1-888-647-6676: Provide pre authorization number for Soldiers to receive care/treatment for payment of medical bills, and coordinate care from civilian sources for duty-related injuries and illness. Soldier must provide them with a copy of LOD in conjunction with orders, and medical bills (if, applicable). (Ideally pre-visitation for medical care/treatment). INCAP (AR 135-381) Provides Soldier with financial support from loss of civilian income due to the incurred military injury with approved LOD.