Pre-Separation Physical

[whatup123]

Anyone had any experience with a pre-separation physical? What does it entail?

[Guest]

This response addresses problems I'm sure you don't have, but it should answer questions other people might have.

Read the DD Form 2697 to get a better idea. It's as in-depth as you want it to be and for as much time as the doc has (which is usually 10 min face time, tops). If you have a lot to discuss, be sure to tell that to the booking nurse/technician and request multiple slots to be combined.

Most of the ones I've read/seen are pretty short and only address one or two things tops. A select few for really broke people are lengthy. They're a good idea if you intend to make a VA disability/injury claim, as it's likely the last medical note from AD that will document the status of your condition. It is not meant to be the document that shows the first instance of a major, chronic medical concern, as you should have brought it up long before.

In fact, if you have had a big medical concern, but kept it to yourself for the last 12 months and suddenly now you want the Air Force to pay you big bucks, you just built your own case against you. My advice to anyone looking to separate/retire, if you want anything really evaluated, but have never brought it up before, start about 18 months out from your final out date. Even if it's a massively disqualifying condition, I-RILO's (Initial Review in Lieu of [Medical Evaluation Board]) take at least 6 months. The majority of the time, you'll be retained on ALC. Even if you lose on the I-RILOand go to full MEB/PEB with early medical separation, you can easily draw out the separation by appealing to SECAF and the Uniform Corrections Board (you have a 99% likelihood of losing the appeals). In the mean time, you'll rack up the months to meet the 20 year minimum, but we're talking about worst case scenario.

Here's an excerpt of the reg that covers what it's for and why you get them:

AFI 48-123

MEDICAL EXAMINATIONS FOR SEPARATION AND RETIREMENT

[...]

8.1. Policy. Do not delay separation or retirement past scheduled date of separation or retirement to complete a medical examination unless medical hold is approved (see AFI 41-210 for further guidance on Medical Hold authority and related topics).

8.2. Purpose. To identify medical conditions requiring attention and to document current medical status to determine continued fitness for duty.

8.3. Presumption of Fitness. If performance of duty in the 12 months before scheduled retirement is satisfactory, the member is presumed to be physically fit for continued active duty or retirement, unless there is clear and convincing evidence to the contrary. (See AFI 41-210 for presumption of fitness prior to retirement) [...]

8.5.1. A medical assessment by a credentialed provider and documented on DD Form 2697 and supporting documents as outlined in 8.5.2 is mandatory when:

8.5.1.1. Member has not had a PHA within one year. [...]

8.5.1.2. Medical authority requires an examination to be done for either clinical or administrative reasons.

8.5.1.3. Separation is involuntary [...]

8.5.1.4. [...] The DD Form 2697 will be accomplished not earlier than 180 days prior to projected separation or retirement and

not later than 30 days prior to projected separation or retirement. [...]

8.5.2.1. The assessment must include:

8.5.2.1.1. A completed DD Form 2697 [...]

8.5.2.1.2. Clear documentation of any significant medical history and/or new signs or symptoms of medical problems since the member’s last medical assessment/medical examination. See the last two sentences in Section II, DD Form 2697 for additional guidance.

[matmacwc]

FInd a cool flight doc, make him sign everything without a meeting, physical done.

[Tank]

They included my pre-separation physical with my annual PHA. Just make sure you have the docs document any problems you think you may have so that when it comes to the VA, it is all in your records.

[Striper_WSO]

They included my pre-separation physical with my annual PHA. Just make sure you have the docs document any problems you think you may have so that when it comes to the VA, it is all in your records.

ANY problems need to be documented in case your problems flare up or worsen down the road.

[Tank]

They included my pre-separation physical with my annual PHA. Just make sure you have the docs document any problems you think you may have so that when it comes to the VA, it is all in your records.

ANY problems need to be documented in case your problems flare up or worsen down the road.

Isn't that what I said?

Edited December 17, 2012 by Tank

[Motrin]

Current flight doc here. I read the boards from time to time and enjoy it, so I figure that I should contribute and make myself useful!

Retirement or voluntary separation physicals are only required if the member has conditions for which he or she is seeking VA disability benefits (ie continued medical care, stipend, etc). All patient conditions which are specifically brought up by the patient will be discussed and examined. Specialty consultation may be required prior to separation. This physical and your medical record will be reviewed by the VA. The VA now does their own independent review and process. You should contact the VA rep in your med group to start this lengthy process immediately.

I see alot of pilots who are retiring in 6 months or so who come in with a laundry list of complaints which they have been stock piling. As a previous poster said, if conditions which are disqualifying for continued flying duties or retention (meaning MEB), you will be grounded and possibly boarded. This could hold up your separation, or your job in the reserves, civilian contractor flying DoD aircraft job, and so on so forth. If it is a legitimate concern, then by all means please discuss it with your physician. Just be aware of the above consequences.

[Learjetter]

Current flight doc here. I read the boards from time to time and enjoy it, so I figure that I should contribute and make myself useful!

Welcome and thank you.

[matmacwc]

Motrin, check in more often.

[Guest]

Welcome and thank you.

Motrin, check in more often.

Almost noone else is active with your level of credentials; post more, if you can.

Retirement or voluntary separation physicals are only required if the member has conditions for which he or she is seeking VA disability benefits

Also required if:

8.5.1.1. Member has not had a PHA within one year...

8.5.1.2. Medical authority requires an examination ...

8.5.1.3. Separation is involuntary ...

[Motrin]

Almost noone else is active with your level of credentials; post more, if you can.

Also required if:

8.5.1.1. Member has not had a PHA within one year...

8.5.1.2. Medical authority requires an examination ...

8.5.1.3. Separation is involuntary ...

I will check in frequently then! For legal purposes I won't post direct medical advice, but aeromedical considerations are fair game.

Thanks, yes I always forget about the PHA time rule since most of my patients are aircrew and are required a (flight) PHA every 12-15 months. Luckily I have great techs which remind me! Also, I have done too many involuntary separation physicals (non continuation, PT failures, RIF, personality disorders, and even for confinement) in my career. Just plain sad.

[discus]

Propose we promote Motrin on the board as well. Seems to me that between him (Her?) and deaddebate, baseops has a pretty powerful medical team, which is awesome!

[Motrin]

I am male.

Thanks for the motivation, i'll check back in as much as I can.

[Guest]

3 Reminders:

1. Separation / Retirement Physicals are now mandatory for everyone and should be completed 6 months before separation / retirement (AFI 48-123, para. 7.5.1.). Technically, you could just complete the DD 2697 without actually seeing the Doc, but I don't know of any base that actually uses this built-in loophole (I know I personally wouldn't sign the form without putting eyes on the member).

2. "... report any new medical condition ... to the appropriate medical provider at the time of onset..." (AFI 10-203, para. 2.18.1.)

3. If you fail to do #2, you might have excluded yourself from disability processing / benefits from the Air Force (AFI 36-3212, para. 3.17. & AFI 41-210, para 4.53.1.). AFPC is scrutinizing I-RILO/MEB packages for this.

DO NOT WAIT UNTIL YOUR SEPARATION / RETIREMENT PHYSICAL TO TELL THE DOC ABOUT (CONDITION X). You should tell your Doc about serious conditions ASAP, but if it slipped your mind, IT IS IN YOUR BEST INTEREST TO HAVE SERIOUS CONDITIONS EVALUATED AT LEAST 18 MONTHS BEFORE SEPARATION / RETIREMENT.

[Guest]

What is the SHPE? Who owns which actions?

The "Separation History and Physical Examination" is a new medical requirement* for separating personnel and is a substantially different change in policy from the current separation physical. Local units will implement as soon as their mission and capabilities allow--the VA/DOD-wide implementation deadline is rumored at Jan 2015. All AD will receive a SHPE before the date of separation. Any RC servicemembers on AD orders for >30 days in support of a contingency operation will receive a SHPE before the date of separation for EACH, future activated period. RC members on AD orders for >180 for training or certain non-mobilization orders instead complete the shorter DD 2697. Reservists not entitled to a SHPE may still request it within 180 days pre-separation. The first step is that the member submits a completed DD 2807-1 to the MSME for review. The MSME will ask if you intend to submit a VA claim.

If the member is not filing a VA claim, the DOD MTF completes the SHPE. The SHPE should be done 90 to 30 days pre-separation, but possibly up to 180 days prior with some additional steps.

If the member is filing a VA claim, the VA clinic completes the SHPE, initiated via the VA eBenefits site. For AD and RC filing a VA claim, it can be completed 180 to 30 days pre-separation. As the VA is infamous for very long delays, you really ought to do it at the 180-day mark.

What are the components of this new exam?

More comprehensive documents (DD 2807-1 and 2808), a face to face with a doc, an audiogram (hearing test), and a record review. Referrals and additional testing are ordered as warranted. Yes, everybody that wanted a hearing test now gets one. How this will be used in consideration of your entrance hearing, age-related hearing loss, non-AF related exposure, and non-HCP (Hearing Conservation Program) folks, I don't know.

Okay, but what is the real bottom line? How does it affect me?

1) For AD, this creates more opportunities for you to be evaluated and submit a VA claim. For those that don't want the exam, it creates more red tape in the separation process. However, it protects the AF when you want to file a claim 30 years later but conveniently omitted your problems from those post-deployment questionnaires and the SHPE. Patient's frequently lie, and it usually hurts them in the long run.

2) RC on temporary AD orders and not permanently separating from the RC are building a case for or against VA and LOD determinations. VA claims must be filed before each separation. LOD claims currently have no timeline restriction per AFI 36-2910, however the pending re-write of this regulation will shorten that to 180 days post-separation. So your options for submitting LOD cases will be greatly reduced, and realistically should be supported by any future SHPE documentation or you'll be fighting a steep, uphill battle. If you have any LOD concerns but have not yet submitted them, I recommend you submit them now and definitely no later than the end of any 180+ day activated period. Otherwise, you may be looking at FFD rather than IDES processing (out-of-pocket vs. AF ownership/disability/benefits) if you have any very major medical problems affecting your retention. Again, this is protecting the AF from heavily delayed LOD/VA claims.

*When is the SHPE not required?

1) The member voluntarily waives the exam and the member's commander concurs, nullifying most options for VA disability claims. This isn't explicit in the AFI but is detailed in the AFMOA SHPE Guide. Member and the MDG would remotely complete a DD 2697 for CYA. This loophole is likely only for unique situations in which the member would be heavily burdened to go to an MTF and has no intention to file any VA claims. Even then, there won't be many of these instances. This policy may change in the future.

2) Member is medically separated following the IDES process (aka the way more detailed and super lengthy MEB). There are MANY opportunities to file a VA claim in this process.

Important Notes

Regulation for this process is the DOD Directive-type Memorandum (DTM) 14-006, published 7 Jul 2014, and implemented by the AF in AFI 48-123, AFGM 2014-01 published 31 Oct 2014. The "AFMOA SHPE Guide" is a mostly-finished AF regulation--it's intended for the test sites but provides some operational guidance to the AF at large. For the purpose of this post, I combined the terms retirement and separation to just separation--the specifics of this program are the same for each. Separation timelines are calculated as the "date of separation" if the member is not taking any terminal leave, or the terminal leave start date if the member is taking terminal leave. AD is Active Duty; RC is Reserve Component. SHPE is pronounced by most folks as "shippy."

[Guest]

Claiming a VA disability, especially for musculoskeletal concerns like back pain or history of broken wrist, after you separate from Active Duty WILL create problems if you try to join the Guard/Reserve. If you are now healthy enough to re-join the AF, why do you still have disability rating from the VA?

"Because I like money" is not a good answer.