Downloaded from https://www.everyspec.com cough at frequent intervals throughout the day or with moderate emphysema with a moderate amount of bronchiectatic sputum or with recurrent pneumonia or with residuals or complications that require repeated hospitalization. d. Bronchitis. Chronic, severe, persistent cough, with considerable expectoration or with dyspnea at rest or on slight exertion or with residuals or complications that require repeated hospitalization. e. Cystic disease of the lung, congenital disease involving more than one lobe of a lung. f. Diaphragm, congenital defect. Symptomatic. g. Hemopneumothorax, hemothorax, or pyopneumothorax.
More than moderate pleuritic residuals with persistent underweight or marked restriction of respiratory excursions and chest deformity or marked weakness and fatigue on slight exertion. h. Histoplasmosis. Chronic and not responding to treatment. i. Pleurisy, chronic, or pleural adhesions. Severe dyspnea or pain on mild exertion associated with definite evidence of pleural adhesions and demonstrable moderate reduction of pulmonary function. j. Pneumothorax, spontaneous . Recurrent episodes of pneumothorax not corrected by surgery or pleural sclerosis. k. Pneumoconiosis . Severe, with dyspnea on mild exertion. l. Pulmonary calcification .
Multiple calcifications associated with significant respiratory embarrassment or active disease not responsive to treatment. m. Pulmonary emphysema . Marked emphysema with dyspnea on mild exertion and demonstrable moderate reduc- tion in pulmonary function. n. Pulmonary fibrosis. Linear fibrosis or fibrocalcific residuals of such a degree as to cause dyspnea on mild exertion and demonstrable moderate reduction in pulmonary function. o. Pulmonary sarcoidosis. If not responding to therapy and complicated by demonstrable moderate reduction in pulmonary function. p. Stenosis, bronchus.
Severe stenosis associated with repeated attacks of bronchopulmonary infections requiring hospitalization of such frequency as to interfere with the satisfactory performance of duty. 3–28. Surgery of the lungs The cause for referral to an MEB is a complete lobectomy, if pulmonary function (ventilatory tests) is impaired to a moderate degree or more. 3–29. Mouth, esophagus, nose, pharynx, larynx, and trachea The causes for referral to an MEB are as follows: a. Esophagus . (1) Achalasia, unless controlled by medical therapy. (2) Esophagitis, persistent and severe.
(3) Diverticulum of the esophagus of such a degree as to cause frequent regurgitation, obstruction, and weight loss that does not respond to treatment. (4) Stricture of the esophagus of such a degree as to almost restrict diet to liquids, require frequent dilatation and hospitalization, and cause difficulty in maintaining weight and nutrition. b. Larynx. (1) Paralysis of the larynx characterized by bilateral vocal cord paralysis seriously interfering with speech and adequate airway. (2) Stenosis of the larynx of a degree causing respiratory embarrassment upon more than minimal exertion. c. Obstructive edema of glottis. If chronic, not amenable to treatment, and requires a tracheotomy. d.
Rhinitis. Atrophic rhinitis characterized by bilateral atrophy of nasal mucous membrane with severe crusting, concomitant severe headaches, and foul, fetid odor. e. Sinusitis. Severe, chronic sinusitis that is suppurative, complicated by chronic or recurrent polyps, and that does not respond to treatment. f. Anosmia. Permanent. g. Trachea. Stenosis of the trachea. 3–30. Neurological disorders The causes for referral to an MEB are as follows: a. Amyotrophic lateral sclerosis and all other forms of progressive neurogenic muscular atrophy. b.
All primary muscle disorders including facioscapulohumeral dystrophy, limb girdle dystrophy, and myotonic dystrophy characterized by progressive weakness and atrophy. c. Myasthenia gravis unless clinically restricted to the extraocular muscles. d. Progressive degenerative disorders of the basal ganglia and cerebellum including Parkinson’s disease, Hun- tington’s chorea, hepatolenticular degeneration, and variants of Friedreich’s ataxia. 31 AR 40–501 • 14 December 2007