Downloaded from https://www.everyspec.com 3–14. Miscellaneous conditions of the extremities The causes for referral to an MEB are as follows (see also paras 3–12 and 3–13): a. Arthritis due to infection, associated with persistent pain and marked loss of function with objective x-ray evidence and documented history of recurrent incapacity for prolonged periods. For arthritis due to gonococcic or tuberculous infection, see paragraphs 3–40 j and 3–45 b . b. Arthritis due to trauma, when surgical treatment fails or is contraindicated and there is functional impairment of the involved joints so as to preclude the satisfactory performance of duty. c.
Osteoarthritis, with severe symptoms associated with impairment of function, supported by x-ray evidence and documented history of recurrent incapacity for prolonged periods. d. Avascular necrosis of bone when severe enough to prevent successful performance of duty. e. Chondromalacia or osteochondritis dissecans, severe, manifested by frequent joint effusion, more than moderate interference with function, or with severe residuals from surgery. f. Fractures. (1) Malunion of fractures, when, after appropriate treatment, there is more than moderate malunion with marked deformity and more than moderate loss of function.
(2) Nonunion of fractures, when, after an appropriate healing period, the nonunion precludes satisfactory perform- ance of duty. (3) Bone fusion defect, when manifested by more than moderate pain and loss of function. (4) Callus, excessive, following fracture, when functional impairment precludes satisfactory performance of duty and the callus does not respond to adequate treatment. g. Joints. (1) Arthroplasty with severe pain, limitation of motion, and of function. (2) Bony or fibrous ankylosis, with severe pain involving major joints or spinal segments in an unfavorable position, and with marked loss of function.
(3) Contracture of joint, with marked loss of function and the condition is not remediable by surgery. (4) Loose bodies within a joint, with marked functional impairment and complicated by arthritis to such a degree as to preclude favorable results of treatment or not remediable by surgery. (5) Prosthetic replacement of major joints if there is resultant loss of function or pain that precludes satisfactory performance of duty. h. Muscles. (1) Flaccid paralysis of one or more muscles with loss of function that precludes satisfactory performance of duty following surgical correction or if not remediable by surgery.
(2) Spastic paralysis of one or more muscles with loss of function that precludes the satisfactory performance of military duty. i. Myotonia congenita. j. Osteitis deformans (Paget’s disease) with involvement of single or multiple bones with resultant deformities or symptoms severely interfering with function. k. Osteoarthropathy, hypertrophic, secondary with moderately severe to severe pain present, with joint effusion occurring intermittently in one or multiple joints, and with at least moderate loss of function. l. Osteomyelitis, chronic, with recurrent episodes not responsive to treatment and involving the bone to a degree that interferes with stability and function. m.
Tendon transplant with fair or poor restoration of function with weakness that seriously interferes with the function of the affected part. (See also paras 3–12 and 3–13.) 3–15. Eyes The causes for referral to an MEB are as follows: a. Active eye disease or any progressive organic disease or degeneration, regardless of the stage of activity, that is resistant to treatment and affects the distant visual acuity or visual fields so that distant visual acuity does not meet the standard stated in paragraph 3–16 e or the diameter of the field of vision in the better eye is less than 20 degrees. b. Aphakia, bilateral. c. Atrophy of the optic nerve due to disease. d.
Glaucoma, if resistant to treatment or affecting visual fields as in a above, or if side effects of required medication are functionally incapacitating. e. Degenerations, when vision does not meet the standards of paragraph 3–16 e , or when vision is correctable only by the use of contact lenses or other special corrective devices (telescopic lenses, etc.). f. Diseases and infections of the eye, when chronic, more than mildly symptomatic, progressive, and resistant to 25 AR 40–501 • 14 December 2007