General Medical Officer (GMO) Manual: Administrative Section
Fitness for duty / Limited Duty (LIMDU) boards
Department of the Navy
Bureau of Medicine and Surgery
Introduction Temporary Limited Duty Important points Medical Evaluation Board Personality disorder Discharge Planning Guide
Medical officers are often asked to make medical evaluations of service members and recommend to commands whether the service member is fit. Fitness is primarily a term that relates to the disability evaluation system. A complete medical board must be dictated for members of other services, for officers, and for any member with a complicated condition who requires a period of limited duty greater than 8 months. Thus, a finding by the Physical Evaluation Board (PEB) that a service member is unfit means that the service member is incapable of performing all the duties required by reason of a diagnosed medical condition. The service member is then rated with a percentage disability, which gives the member that percentage base pay as disability compensation. A rating of disability ensures that the member is eligible for medical care from the Department of Veterans Affairs for that medical condition. Members do not need a disability rating from the military to be eligible for VA health care and benefits.
Physicians, usually specialists, will dictate a medical evaluation board (MEB) when they feel a member will not be fit for duty within 16 months. The Medical Boards Office in the MTF’s Patient Administration Department will coordinate the MEB. The MEB package also includes a complete physical examination (PE), non medical assessment (NMA) from the member's commanding officer, line of duty determination/investigation (LODD/LODI) if necessary, Comprehensive Clinical Evaluation Program (CCEP), (if the member served in the Persian Gulf (Jan 91 to present), complete copy of the outpatient medical record (and inpatient records if applicable), and any addenda from other specialists.
You may put any active duty Navy or Marine Corps enlisted member on temporary limited duty by using the NAVMED 6100/5. The physician completes the top portion of the form for all such members with uncomplicated illness or injury and expected return to full duty within 16 months. The recommended periods of limited duty are 8 and/or 16 months, for a total of 16 months for any one condition. This is to allow for adequate time frames for treatment and re-evaluation. You may find the member fit at any period during limited duty. There is currently no limit of temporary limited duty (TLD) per career, but physicians should check with the patient administration department or medical boards supervisors to identify any trends for a particular member before placing them on TLD.
Personality disorders are medical diagnoses that describe long-term patterns of adult behavior and often, but not always, have significant impact on a member's ability to perform his or her job. A psychiatrist or psychologist is the designated competent authority to diagnose these conditions and make recommendations to commands for appropriate administrative disposition. Personality disorders do not rate disability evaluation; therefore, no medical board should be prepared. When you suspect a service member is having trouble due to personality disorder, refer documentation to the Patient Administration Department for a message to be prepared for administrative separation of the member.
- Most patients who are unfit and need medical boards should be referred to appropriate specialists for definitive diagnosis, treatment, and preparation of the medical board, if necessary.
- Operational and remote duty suitability screening should be completed on all members being found fit from a period of TLD and after a finding of "fit for continued naval service" by the PEB.
Military Patient Discharge Planning Guide
Acute Care Completed |
The Patient Can Be |
By |
Fit for full duty. |
Discharged to full duty. |
Dictating narrative summary. |
Not able to work at normal job. No additional hospitalization required. |
Sent to quarters for a period up to, but normally not exceeding 14 days. |
Dictating narrative summary stating day and time for reexamination and clearly indicating why inpatient care is no longer required. Also include self-care instructions. |
Partially able to work at normal job or related military duties of about 50-70 percent capability for a short period (less than 30 days). |
Sent to light duty under treatment |
Dictating narrative summary stating limitations, period of time involved, and indicating the day and time for reexamination. Also include self-care instructions. |
No longer requires nursing care on the ward but needs to be seen daily and is partially able to work. |
Transferred to a medical holding company if authorized and available. |
Discharging patient to medical holding company. Dictating narrative summary specifying follow-up care and period of time involved. Also include self-care instructions. |
No longer needs ward care or to be seen daily but has frequent therapy schedule and is partially able to work. |
Same as above. |
Same as above. |
No longer needs ward care but not fit to work and needs to be seen at least weekly. |
Subsisted out if appropriate, or transferred to a medical holding company if not a member of a local command. |
Submitting appropriate local forms for subsisting out and providing self- care instructions. Dictating a narrative summary, stating therein when, where, and how frequently patient is to be seen. Also provide self-care instructions. Upon completion of final treatment, write an addendum on the SF 600 in the Health Record. |
No longer needs ward care and does not need to be seen for up to 30 days, but scheduled for further medical or surgical care and is not fit for duty. |
Granted convalescent leave an appropriate number of days generally not exceeding 30. |
Submitting NAVPERS 1336/3. Special Request/ Authorization, via the chain of command to commanding officer. Furnish self-care instructions. |
No longer needs ward care, not fit for duty but expected to be fit for duty after period of convalescence. |
Discharged from the hospital to begin convalescent leave. Can be granted as delay in reporting to the patient's command. |
Dictating narrative summary expressing preference and recommending an appropriate number of days of convalescent leave. Also furnish self-care instructions. |
Reviewed by LCDR Robert A. Rahal, MSC, USN, Assistant Specialty Leader for Patient Administration, (MED-31) Bureau of Medicine and Surgery, Washington, D.C. (1999).