Downloaded from https://www.everyspec.com g. Menopausal syndrome, physiologic or artificial, when symptoms are not amenable to treatment and preclude successful performance of duty. h. Chronic pelvic pain with or without demonstrative pathology that has not responded to medical or surgical treatment and of such severity to necessitate recurrent absence from duty. i. Strictures of the urethra or ureter, when severe and not amenable to treatment. j. Urethritis, chronic, when not responsive to treatment and necessitating frequent absences from duty. 3–18. Genitourinary and gynecological surgery The causes for referral to an MEB are as follows: a. Cystectomy. b.
Cystoplasty, if reconstruction is unsatisfactory or if residual urine persists in excess of 50 cubic centimeters or if refractory symptomatic infection persists. c. Hysterectomy, when residual symptoms or complications preclude the satisfactory performance of duty. d. Nephrectomy, when after treatment, there is infection or pathology in the remaining kidney. e. Nephrostomy, if drainage persists. f. Oophorectomy, when complications or residual symptoms are not amenable to treatment and preclude successful performance of duty. g. Pyelostomy, if drainage persists. h. Ureterocolostomy. i. Ureterocystostomy, when both ureters are markedly dilated with irreversible changes. j.
Ureteroileostomy cutaneous. k. Ureteroplasty. (1) When unilateral procedure is unsuccessful and nephrectomy is necessary, consider it on the basis of the standard for a nephrectomy; or (2) When bilateral, evaluate residual obstruction or hydronephrosis and consider it on the basis of the residuals involved. l. Ureterosigmoidostomy. m. Ureterostomy, external or cutaneous. n. Urethrostomy, if there is complete amputation of the penis or when a satisfactory urethra cannot be restored. o. Kidney transplant recipient. If found fit for duty by a PEB, Soldiers should be restricted to assignment locations where adequate medical care is available and should not deploy to an austere environment.
Such Soldiers should not wear individual chemical equipment due to possible drug interactions. 3–19. Head A skull defect that poses a danger to the Soldier or interferes with the wearing of protective headgear is cause for referral to an MEB. 3–20. Neck The causes for referral to an MEB are torticollis (wry neck); severe fixed deformity with cervical scoliosis, flattening of the head and face, and loss of cervical mobility. (See also paras 3–11 and 3–39 h .) 3–21. Heart The causes for referral to an MEB are as follows (see table 3–1 for functional classifications and for metabolic equivalents (METS) ratings to be included in the MEB): a.
Coronary heart disease associated with— (1) Myocardial infarction, angina pectoris, or congestive heart failure due to fixed obstructive coronary artery disease or coronary artery spasm. The policies for trial of duty, profiling, and referral to an MEB and a PEB (as outlined in para 3–25) apply. The trial of duty will be for 120 days. (2) Myocardial infarction with normal coronary artery anatomy. The policies for trial of duty, profiling, and referral to an MEB and a PEB (as outlined in para 3–25) apply. The trial of duty will be for 120 days. (3) Angina pectoris in association with objective evidence of myocardial ischemia in the presence of normal coronary artery anatomy.
(4) Fixed obstructive coronary artery disease, asymptomatic but with objective evidence of myocardial ischemia. The policies for trial of duty, profiling, and referral to an MEB and a PEB (as outlined in para 3–25) apply. The trial of duty will be for 120 days. b. Supraventricular tachyarrhythmias, when life threatening or symptomatic enough to interfere with performance of duty and when not adequately controlled. This includes atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia, and others. 27 AR 40–501 • 14 December 2007