Downloaded from https://www.everyspec.com (1) For purposes of this regulation, upper extremity amputation is defined as the loss of part or parts of an upper extremity equal to or greater than-- (a) A thumb proximal to the interphalangeal joint. (b) Two fingers of one hand, other than the little finger, at the proximal interphalangeal joints. (c) One finger, other than the little finger, at the metacarpophalangeal joint and the thumb of the same hand at the interphalangeal joint.
(2) Soldiers with amputations will (assuming no other disqualifying medical conditions) be provided a temporary profile not less than 4 months (but not to exceed 1 year) to enable the Soldier to attain maximum medical benefit. b. Joint ranges of motion (ROM) which do not equal or exceed the measurements listed below. Measurements should be made with a goniometer (a bubble goniometer/inclinometer is also acceptable) and conform to the methods illustrated and described in the Veterans Administration Schedule for Rating Disabilities (VASRD). SF Form 527 (Medical Record—Group Muscle Strength, Joint R.O.M.
Girth and Length Measurements) should be used to document the ROM and the method of measurement. (1) Shoulder—forward elevation to 90 degrees, or abduction to 90 degrees. (2) Elbow—flexion to 100 degrees, or extension to 60 degrees. (3) Wrist—a total range extension plus flexion of 15 degrees.
(4) Hand (for this purpose, combined joint motion is the arithmetic sum of the motion at each of the three finger joints (VASRD))—an active flexor value of combined joint motions of 135 degrees in each of two or more fingers of the same hand, or an active extensor value of combined joint motions of 75 degrees in each of the same two or more fingers, or limitation of motion of the thumb that precludes opposition to at least two finger tips. c. Recurrent dislocations of the shoulder, when not repairable or surgery is contradicated. 3–13. Lower extremities The causes for referral to an MEB are as follows (see also para 3–14): a. Amputations.
(1) Lower extremity amputations are defined, for purposes of this regulation, as follows: (a) Loss of toes that precludes the abilities to run or walk without a perceptible limp and to engage in fairly strenuous jobs. (b) Any loss greater than that specified above to include foot, ankle, below the knee, above the knee, femur, hip. (2) Soldiers with amputations will (assuming no other disqualifying medical conditions) be provided a temporary profile not less than 4 months (but not to exceed 1 year) to enable the Soldier to attain maximum medical benefit. b. Feet. (1) Hallux valgus when moderately severe, with exostosis or rigidity and pronounced symptoms; or severe with arthritic changes.
(2) Pes planus, when symptomatic, more than moderate, with pronation on weight bearing which prevents the wearing of military footwear, or when associated with vascular changes. (3) Pes cavus when moderately severe, with moderate discomfort on prolonged standing and walking, metatarsalgia, and which prevents the wearing of military footwear. (4) Neuroma that is refractory to medical treatment, refractory to surgical treatment, and interferes with the satisfactory performance of military duties.
(5) Plantar fascitis or heel spur syndrome that is refractory to medical or surgical treatment, interferes with the satisfactory performance of military duties, or prevents the wearing of military footwear. (6) Hammertoes, severe, that precludes the wearing of appropriate military footwear, refractory to surgery, or interferes with satisfactory performance of duty. (7) Hallux limitus, hallux rigidus. c. Internal derangement of the knee. (1) Residual instability following remedial measures, if more than moderate in degree. (2) If complicated by arthritis, see paragraph 3–14 a . d. Joint ranges of motion (ROM). ROM that does not equal or exceed the measurements listed below.
Measurements should be made with a goniometer (a bubble goniometer/inclinometer is also acceptable) and conform to the methods illustrated and described in the VASRD. (1) Hip—flexion to 90 degrees or extension to 0 degree. (2) Knee—flexion to 90 degrees or extension to 15 degrees. (3) Ankle—dorsiflexion to 10 degrees or planter flexion to 10 degrees. e. Shortening of an extremity that exceeds 2 inches. f. Recurrent dislocations of the patella. (See also para 3–14.) 24 AR 40–501 • 14 December 2007