Downloaded from https://www.everyspec.com (2) Numerical designator “2.” Individuals with minor physical activity limitations or who require frequent medical follow–up. (3) Numerical Designator “3.” Individuals who are asymptomatic but with objective evidence of myocardial is- chemia or other cardiovascular functional abnormality. Those requiring assignment limitations. (4) Numerical designator “4.” Individuals who are symptomatic (New York Heart Association Functional Class II or worse). 3–26. Tuberculosis, pulmonary The causes for referral to an MEB for pulmonary tuberculosis: a. If an expiration of service will occur before completion of the period of hospitalization.
(Career Soldiers who express a desire to reenlist after treatment may extend their enlistment to cover the period of hospitalization.) b. When a member of the USAR or ARNG/ARNGUS not on active duty has active disease that will probably require treatment for more than 12 to 15 months including an appropriate period of convalescence before he or she can perform full-time military duty. Individuals who are retained in the USAR or ARNG/ARNGUS while undergoing treatment may not be called or ordered to active duty (including mobilization), ADT, or inactive duty training (IDT) during the period of treatment and convalescence. 3–27.
Miscellaneous respiratory disorders The causes for referral to an MEB are as follows: a. Asthma . This includes reactive airway disease, exercise-induced bronchospasm, asthmatic bronchospasm, or asthmatic bronchitis within the criteria outlined in paragraphs (1) through (4) below. (1) Definitions/diagnostic criteria are as follows. (a) Asthma is a clinical syndrome characterized by cough, wheeze, or dyspnea and physiologic evidence of reversible airflow obstruction or airway hyperactivity that persists over a prolonged period of time (generally more than 6 to 12 months).
(b) Reversible airflow obstruction is defined as more than 15 percent increase in forced expiratory volume in 1 second (FEVI) following the administration of an inhaled bronchodilator or prolonged corticosteroid therapy. (c) Increased bronchial responsiveness is the presence of an exaggerated decrease in airflow induced by a standard bronchoprovocation challenge such as methacholine inhalation (PD20 FEV1 less than or equal to 4mg/ml). Demonstra- tion of exercise induced bronchospasm (15 percent decline in FEV1) is also diagnostic of increased bronchial responsiveness; however, failure to induce bronchospasm with exercise does not rule out the diagnosis of asthma.
Bronchoprovacation or exercise testing should be performed by a credentialed provider privileged to perform the procedures. (d) If at the end of that period, the Soldier is unable to perform all military training and duty as cited below, the Soldier will be referred to MEB. (e) Acute, self limited, reversible airflow obstruction and airway hyperactivity can be caused by upper respiratory infections and inhalation of irritant gases or pollutants. This should not be permanently diagnosed as asthma unless significant symptoms or airflow abnormalities persist for more than 12 months.
(2) Chronic asthma is cause for a permanent P-3 or P-4 profile and MEB referral if it— (a) Results in repetitive hospitalizations, repetitive emergency room visits or excessive time lost from duty. (b) Requires repetitive use of oral corticosteroids to enable the Soldier to perform all military training and duties. (c) Results in inability to run outdoors at a pace that meets the standards for the timed 2-mile run despite medications.
(The P–3 for the inability to perform the run refers to the inability due to asthma and should not be confused with giving an L2 or L3 based on an underlying orthopedic condition that requires an alternate Army Physical Fitness Test (APFT).) (d) Prevents the Soldier from wearing a protective mask. (3) All Soldiers meeting an MEB for asthma should receive a consultation from an internist, pulmonologist, or allergist.
(4) Chronic asthma meets retention standards, but is a cause for a permanent P–2 profile if it— (a) Requires regular medications including low dose inhaled corticosteroids and/or oral or inhaled bronchodilators; but (b) Does not prevent the Soldier from otherwise performing all military training and duties including the 2 mile run within time standards. (5) Soldiers with a diagnosis of asthma who require no medications or activity limitations require no profiling action. b. Atelectasis, or massive collapse of the lung.
Moderately symptomatic with paroxysmal cough at frequent intervals t h r o u g h o u t t h e d a y o r w i t h m o d e r a t e e m p h y s e m a o r w i t h r e s i d u a l s o r c o m p l i c a t i o n s t h a t r e q u i r e r e p e a t e d hospitalization. c. Bronchiectasis or bronchiolectasis. Cylindrical or saccular type that is moderately symptomatic, with paroxysmal 30 AR 40–501 • 14 December 2007