Upon receipt of accompanied orders overseas or to a remote assignment, the member and, as applicable, his family members will be screened to determine their physical and psychological suitability for transfer. Service members and families who are not screened- or who are improperly screened-can arrive at a duty station with requirements beyond the capability of the local medical, dental, educational, or community facilities. This may result in decreased quality of life, early return from assignment, billet gaps, etc. Proper screening helps ensure a positive and productive tour for the service member. All screening should be completed within 30 days of receipt of orders.

OCCUPATIONAL HEALTH MEDICAL SURVEILLANCE EXAMINATIONS

The Navy uses many materials in its work places, some of which are potentially hazardous to personnel. To minimize the risk associated with these hazardous substances, the Navy developed the Navy Occupational Safety and Health (NAVOSH) Program, OPNAVINST5100.23. Within the NAVOSHProgram is the Medical Surveillance Program. The Medical Surveillance Program provides physical examination and medical monitoring guidelines for personnel who are exposed to or work with hazardous materials.

Medical surveillance examinations assess the health status of individuals as it relates to their work. Although these exams are not physical examinations as described in this chapter, they are actually surveillance examinations that produce specific information with regard to an individual's health during actual or potential exposure to hazardous materials (i.e., the Asbestos Medical Surveillance Program [AMSP]). Specific guidance on the Asbestos Medical Surveillance Program is provided in OPNAVINST 5100.23. Another example of a medical surveillance program is the Occupational Noise Control and Hearing Conservation Program. Personnel who work in areas of high sound generation (e.g., flight deck of carrier) must be evaluated periodically for hearing loss. Specific guidance on the Occupational Noise Control and Hearing Conservation Program is provided in NAVMEDCOMINST 6260.5 and OPNAVINST 5100.23.

MEDICAL BOARD EXAMINATIONS AND REPORTS

Medical review boards are the single most important factor in determining fitness for duty in today's Navy. Medical boards are convened and reviews are conducted to determine the various degrees of fitness for military service. Local (re)evaluations are scheduled to assess patient progress and length of limited duty, or need for a formal evaluation at NAVPERSCOM or the Physical Evaluation Board (PEB). The following examples illustrate the legal guidelines, requirements, and job descriptions for the different types of medical boards and describe the duties of the personnel responsible.

Abbreviated Temporary Limited Duty (TLD) Medical Board Report

The abbreviated board report is used only when a member is expected to return to full duty after an adequate period of treatment. Processing time should not exceed 6 working days, and under most circumstances, the report should be completed in 3 working days. The board report is a local action taken by an appropriate medical or dental officer and does not require external departmental review by NAVPERSCOM. The form (NAVMED 6100/5) used for this report is a multi-copy form. It is a vehicle for recording basic medical findings, plans, and expectations in terms of prognosis and length of medical restriction of activity. It also provides for parent command acknowledgment and comment. This form serves as excellent input for the "putting performance into practice" form in the member's health record; however, it is not a substitute for detailed documentation of conditions in the member's health record. The Abbreviated TLD Medical Board Report (NAVMED6100/5) is to be used when all of the following criteria are met:

The member is enlisted in the U.S. Navy or Marine Corps.

The member suffers from an uncomplicated illness or injury which makes them temporarily unable to fully perform duties to which they are assigned or expected to be assigned, but will most likely be fit for full duty after an adequate period of treatment not exceeding 8 months.

The member's health or clinical record contains adequate documentation on the nature and circumstances of the illness or injury, its course, prognosis, and treatment.

Patient (Re)evaluation/TLD Duration
Once a member has been placed on TLD, the physician, dental officer, or Independent Duty Corpsman (IDC) (when in an independent operational duty environment), will

conduct a detailed treatment/rehabilitation assessment and develop a treatment/ rehabilita- tion plan;
ensure follow-up evaluations every 2 months, documenting at each evaluation objective findings of continued unsuitability, progress toward recovery, findings and recommendations of specialty evaluations, modifications to the treatment/ rehabilitation plan, and prognosis for return to worldwide assignability; and

obtain approval from NAVPERSCOM (NPC-821) or CMC (MMSR-4), via the patient administration Limited Duty (LIMDU) Coordinator for periods of TLD less than 8 months, or via a formal board (NPC-821 or MMSR-4) for periods longer than 8 months.

Approval must be obtained via formal board if the initial recommended period of TLDexceeds 8 months, and the total period a member can be on LIMDU must not exceed 16 months.

Uncorrected Condition
If the servicemember's condition cannot be corrected during the initial or subsequent period of TLD and treatment, or if it is clear that the condition will continually interfere with or preclude his ability to function effectively in an operational arena or to deploy worldwide, notify the transferring or parent command and NAVPERSCOM. Subsequent to the second period of TLD, if appropriate, a Physical Evaluation Board (PEB) will adjudicate the case. If the PEB (in Washington, DC) finds the member "fit to continue Naval Service," NAVPERSCOM will direct the command to initiate appropriate administrative action, which may include a recommendation of administrative separation (per MILPERSMAN 1910-120).

Formal Board Report
If conditions warrant (i.e., when the period of recovery is expected to exceed 8 months), the physician or dental officer will dictate a formal board report in accordance with SECNAVINST 1850.4 and MANMED, chapter 18, for submission to NAV- PERSCOM (NPC-821). The LIMDU Coordinator is responsible for reviewing the medical board, verifying the content and that the processing time is consistent with current policy. However, a command endorsement is not required on a formal board.