General Medical Officer (GMO) Manual: Administrative Section
Competence for Duty Examination
Department of the Navy
Bureau of Medicine and Surgery
Introduction Body fluid sampling Final Notes Who is authorized Requesting an exam BUMED Instruction 6120.20B.
A competence for duty examination is performed to determine if a service member's mental or physical faculties are so far impaired by intoxicating beverages, drugs, disease, injury, or any other exposure or circumstances to hinder the safe and efficient performance of military duties. The purpose of this exam is to prevent injuries or death and to protect the health and well being of service members and others who may be affected by their performance.
Who is authorized to perform this exam
A medical officer will perform competence for duty examinations. In the absence of a medical officer and with the approval of the commanding officer, an independent duty corpsman, (NEC 8425), shall perform the competency for duty examination. Operational circumstances permitting, an independent duty corpsman shall seek consultation with a medical officer whenever there is doubt about a patient’s condition or treatment.
The medical officer performing the examination decides whether or not it is necessary to take samples of bodily flubs to determine competence for duty. Even though reference (a) discourages drawing samples of body fluids, clinical practice has shown that history and physical examinations are not always adequate indicators of level of intoxication (e.g., service member with blood alcohol concentration (BAC) of 550 mg percent, with no signs or symptoms of intoxication). Medical officers are urged to get body fluids samples (e.g., saliva for salivary alcohol level), and correlate the results with other documentation in making a competence for duty determination.
- If body fluid samples are needed for therapeutic purposes, such samples may be used for both medical and appropriate evidentiary purposes.
- If body fluid samples are requested by law enforcement personnel or other authority, there is no medical necessity for them, medical personnel may assist in drawing the samples subject to the following restrictions:
- Medical personnel will not assist in taking body fluid samples against a patient's will, unless a valid search warrant or command authorization has been issued.
- Medical personnel will not assist in acquiring evidence solely to enforce local, State, or Federal civil laws.
- Body fluid samples will not be taken if doing so would endanger the life of the patient.
- "Legal" samples need to be handled via a chain of custody.
Personnel authorized to request an exam
The person requesting the competence for duty examination completes part A of enclosure (1) (NAVMED 6120/1),
contained in the instruction. If part A of enclosure (1) is properly completed and is signed by a person with apparent authority to request a competence for duty examination, medical personnel will not question or challenge the validity of the request. In general, the member’s commanding officer or any other person in the member’s chain of command exercising authority over the member may request a competence for duty examination.
After completing the competence for duty examination, the medical officer shall complete parts B, C, D (if applicable), E, and F of enclosure (1). Give the original of enclosure (1) to the person escorting the member, or otherwise ensure the original is conveyed to the member's command. A copy of enclosure (1) should be placed in the member's health record if it is available.
Although the competence for duty examination is not performed to obtain evidence that may be used for disciplinary action, and although the results of any laboratory analysis on any body fluid samples taken during the course of the examination may not be used for disciplinary action, the information contained in parts B, C, and E of enclosure (1) of BUMED Instruction 6120.20 can be used as the basis for disciplinary action. Medical officers shall provide as much detail as possible in parts B, C, and E, and be sure to complete blocks 44 through 48 of enclosure (1).
Reference
Submitted by CAPT B. Gill, MC, USN, Commanding Officer Naval Addictions Rehabilitation and Education Department. Reviewed by LT Denis Ashley, MC, USNR, GMO Policy and Plans, O0MC, BUMED, Washington, D.C. (1999).