DEPARTMENT OF THE ARMY

HEADQUARTERS, USA MEDICAL DEPARTMENT ACTIVITY 126 MISSOURI AVENUE FORT LEONARD WOOD, MISSOURI 65473-8952
REPLY TO ATTENTION OF

MCXP-MD MEMORANDUM THRU Fort Leonard Wood Battalion Commander FOR Commander, Soldier’s Unit SUBJECT: Assignment of Soldier(s) with Complex Medical Needs to WTU 1. References.

18 July 2007

a. HQDA EXORD 118-07 AMAP Healing Warriors dated 021000Q JUN 2007, Annex S b. USAMEDCOM Operation Order 07-55 (MEDCOM Implementation of the Army Medical Action Plan (AMAP)) dated 050522Q JUN 07, Annex I c. AR 40-400, Patient Administration d. DA Personnel Policy Guidance (PPG) e. DA Medical Hold Over Consolidated Guidance (MHOCG) 2. Definition of Warrior in Transition (WT): a Warrior in Transition is any Medical Holdover, Active Duty Medical Extension, Medical Hold and any other Active Component Soldier who requires a Medical Evaluation Board. It includes any Active Duty Soldier with complex medical needs who requires a temporary profile of more than 6 months duration, and whose duty limitations preclude the Soldier from contributing to the parent unit’s mission. It excludes Soldiers in Initial Entry Training, Advance Individual Training, and One Station Unit Training, except in extraordinary circumstances. Unit Commanders must clear Uniform Code of Military Justice (UCMJ) actions, other legal actions, investigations, property/hand receipt issues and Line of Duty determinations prior to the transfer to the WTU. 3. Per guidance provided in reference 1.b., MTF Commanders must establish a process to receive, approve/disapprove and respond to Unit Commander nominations for attachment or assignment of Soldiers to the Warrior in Transition Unit (WTU). Unit Commanders may nominate Soldiers that have complex medical needs requiring six months or more of complex or focused clinical care. Referral criteria and procedures are as follows: a. Soldier must meet the definition in paragraph 2 above and applicable guidelines contained in references 1.a. through 1.d. Soldiers meeting the definition may include T-3 or T-4 profiles whose frequency of appointments will significantly preclude them from performing their regular duties for an extended period. b. Unit Commanders will provide a complete nomination packet in hard copy to the MTF, containing:

MCHK-PDT SUBJECT: Re-assignment of Soldier(s) with Complex Medical Needs to WTU

(1) A letter of request from the Commander for the Soldier's reassignment to the WTU. The letter will offer justification for reassignment and will detail the source of the Soldier's profile injury and provide information on what rehabilitative measures have been taken. A sample letter is provided as Enclosure 1. (2) DA Form 5889-R, MEB/PEB Document Checklist, which confirms all unit-level personnel and administrative requirements are completed prior to reassignment transaction. If the Soldier is not undergoing an MEB, provide the information contained under Personnel Documents and RC/NG Documents (if applicable) with the request for transfer. The checklist is provided as Enclosure 2. (3) Commander's Certification that verifies the Soldier is cleared of any UCMJ actions, legal actions, investigations, or property/hand receipt issues and has cleared the unit. Transferable flags will move with the Soldier to the WTU with coordination with the gaining commander. The Commander’s Certification document is provided as Enclosure 3. c. The (Cdr/1SG in WTU) will interview the Soldier prior to finalizing transfer. d. The MTF Commander will provide a formal written reply and email to the Unit Commander approving or disapproving transfer to the WTU. You may expect a response to your nomination request within 14 working days but NLT 30 working days after receipt of the action. e. IAW G-1 guidance, the losing command is responsible for coordinating appropriate attachment or assignment orders. 4. The MTF will begin accepting nominations after 27 August 2007. The POC is CPT Czarvitto Rogers, Email: Czarvitto.Rogers@amedd.army.mil, Office: (573) 596-0490 / Cell: (573) 8556263.

3 Encls 1. Sample Commander’s Statement 2. DA Form 5889-R, PEB/MEB Checklist 3. Commander’s Certification

//ORIGINAL SIGNED// THERESA M. SULLIVAN COL, AN Commanding

CF: WTU Company Commander, General Leonard Wood Army Community Hospital, Fort Leonard Wood, MO 65473

2

SAMPLE COMMANDER’S STATEMENT
Office Symbol MEMORANDUM THRU UNIT BN CDR FOR Commander, Warrior Transition Unit, Commander, General Leonard Wood Army Community Date

Hospital, Fort Leonard Wood, MO 65473
SUBJECT: Commander’s Statement, SPC John Broken, (last SSN 4) 9999 1. Request SPC Broken be reassigned to the Medical Processing Company (MPC), Warrior Transition Company, General Leonard Wood Army Community Hospital, Fort Leonard Wood, MO 65473 DATE:________________ 2. PAST HISTORY: a. SPC Broken’s medical condition began after a difficult landing during an airborne operation when he injured his left knee. He is a Combat Engineer, which requires extensive marching, running and frequent manual labor. Over the past five months, he was on 30-day limited duty profiles on three occasions. b. SPC Broken’s condition has only worsened. He was scheduled for arthroscopic surgery. Following his surgery, SPC Broken returned to work, only to find that his condition had not improved. He could not meet the physical demands of his job without extensive pain. c. Later, SPC Broken was diagnosed with Osgood-Schlatter disease and has been confirmed twice more since that date. His right knee began to suffer the same symptoms as his left and he was assigned as a driver to reduce the stress on his knees. He cannot walk without pain and is assigned to the CQ desk to continue rehabilitation. He was the referred to the PEB process by the hospital staff on ______(date). Medications have not eased his constant pain. 3. PRESENT CONDITION: a. SPC Broken remains well motivated, and provides the leadership characteristics that had him ready to become a Non-Commissioned Officer but is limited physically. b. As a Combat Engineer, SPC Broken’s physical condition prevents him from performing his duties. He has made every effort to rehabilitate himself, to include surgery. The Fort Hood hospital staff concludes that the Osgood-Schlatter disease is not curable. I ask that he be reassigned to the Warrior Transition Unit and be processed through the Physical Evaluation process.

CDR Signature Block

DA Form 5889-R “PEB Referral Transmittal Document” MEB Documents (in this order) a MEB Proceedings (DA Form 3947 or appropriate Interservice/Triservice MEB) b PEBLO Statement of Waiver (if Soldier failed to sign MEB) c Next of Kin or Guardian Statement (if applicable) d MTF’s response to Soldier’s rebuttal e Soldier’s MEB Rebuttal f NARSUM g Addendum/s h Additional Medical Documents supporting NARSUM or Addendum i Medication Profile j Physical Exam (DD Form 2808 & DD 2807-1) k Physical Profile (DA Form 3349) Personnel Documents (in this order) a Personnel Certificate b GCMCA decision to waive administrative separation under AR 635-200, Chapter 7, sec. IV; 14, 15. c Article 15 (if less than two years old) or other flagging statement d Statement explaining reduction to lower grade or precluding advancement under AR 600-8-19, as appropriate e Document authorizing Soldier’s retention beyond scheduled separation or retirement date f Retirement Orders, amendments and/or revocations g Grade Determination (if applicable) h Commander’s Letter/Statement (See PDA Memo #8 for physician cases) i Approved LOD Decision (DD Form 261/DA Form 2173) (when required) j OERs / NCOERs and or Developmental Counseling- Last three (as applicable) k APFT Scorecard (or statement non- availability) l MMRB (Medical/MOS Retention Board) if applicable m ORB/ERB/PQR/ Officer /Enlisted Record Brief, Personnel Qualification Record or Equivalent n LES Leave and Earnings Statement (DFAS Form 702) RC/NG Documents a Individual Mobilization Orders to also include extension orders, if applicable b MHO/ADME c Attachment Orders d Training Orders e Training Schedule f 15/20-Year Letter g CBHCO h Retirement Points Statement (NGB Form 23 or ARPC Form 249-2-E) – Thru current RYE COAD/COAR Request (may provide with either MEB or with informal election) Additional or Allied Documents (including copy of request for VA Hospital bed designation, orders moving Soldier to VA Hospital for continued hospitalization, etc.) HREC (Health and Clinical Records; to include VA records, as applicable)

SOLDIER’S NAME:__________________________ RANK:_____________________________________ UNIT:______________________________________

1. Service data: Circle the applicable response. a. Estimated Termination Service (ETS): Soldier’s ETS (will) (will not) occur during the next 12 months. (Note: If ETS will occur, See AR 635-200, para 1-24 for retention procedures for AD enlisted, to include AGR, and AR 600-8-24, para 1-22 and 1-23 for AD officers, to include AGR.) b. Basic Active Service Date (BASD) All components on Active Duty (AD): Soldiers BASD has been reviewed and confirmed to be __________. c. For RC Soldiers to include Active Guard Reserve (AGR): A current retirement points statement thru current retirement year ending date (is attached) (will be faxed to the Physical Evaluation Board Liaison Officer (PEBLO)). 2. Under investigation: Circle applicable phrase. Soldier (is) (is not) charged or under investigation for an offense chargeable under the Uniformed Code of Military Justice (UCMJ) which could result in dismissal or punitive discharge. (Note: Not eligible for MEB/PEB. Officers resigning for the good of the service and enlisted separating in lieu of court martial (AR 635-200, chapter 10) also fall under this category). 3. Administrative separation: Circle applicable phrase. Soldier (is) (is not) pending voluntary or involuntary administrative separation under AR 635-200 (enlisted) or AR 600-8-24 (officer). If yes, specify the chapter and the paragraph. (Note: Enlisted administrative separations under AR 635-200, chapters 7 (section IV), 14, or 15, remain eligible for (MEB) but require GCMCA decision for PEB. MEB/PEB has precedence for all others. See para 1-33. Officers are dual processed except for resignation for the good of the service. See AR 600-8-24, para 1-23). ____________________________________________________ 4. Pending voluntary/involuntary retirement: (Circle applicable phrase. Add requested information when applicable.) a. Soldier (is) (is not) pending voluntary retirement. If yes, list date request for retirement was approved: ___________________. b. Officer (is) (is not) within 12 months of mandatory retirement for age or years of service. If yes, list mandatory retirement date. ____________. c. If RC, Soldier (is) (is not) within 12 months of mandatory removal date? If yes, date of mandatory removal is: ___________. If yes, Soldier (does) (does not) have 20 qualifying years of service for non-regular retirement. d. For cases of AC enlisted Soldiers: Soldier (is) (is not) within 12 months of Retention Control Point (RCP) with eligibility for length of service retirement at RCP. If yes, list RCP date: __________.

5 Enclosure 3

e. For cases in which retirement was affected by Stop Loss: If Soldier’s retirement was delayed by Stop Loss, list the applicable Stop Loss MILPER message (Note: Whether retirement was “revoked” versus “suspended” impacts on “presumption of fitness rule”): _____________ 5. Pending promotion. Circle the applicable statement (Note: Under 10 USC 1372(3)(4) Soldiers on a promotion list will be retired at promotion list rank; under 1212(c)ii Soldiers on a promotion list will receive disability severance pay at promotion list rank. Applies to automatic promotion to PV2, PFC, and SPC and from 2LT through CPT). a. Soldier (is) (is not) on a centralized promotion list. b. Soldier (is) (is not) on a semi-centralized promotion list and (does) (does not) meet the cutoff score. c. For Soldiers who fall under automatic promotion, show the date Soldier will be due next automatic promotion: 6. Grade determination: (Complete statement with applicable information; otherwise state “NA.”) (Note: An option under 10 USC 1372 and 10 USC 1212 is highest grade satisfactorily served. HQUSAPDA must refer cases involving disciplinary reductions and former officer rank not held the required time to the Grade Determination Review Board) Soldier has previously held a higher rank of _________ for ________ (number of months). (Provide documentation for PEB case file.) Explain reason for reduction in rank: _______________________________________________________________ ________________________________________________________________ ________________________________________________________________ 7. 24 September 1975: (Circle the applicable phrase.) On 24 September 1975, the Soldier (was) (was not) a member of the Armed Forces, to include the Reserve components, the National Oceanic and Atmospheric Administration (NOAA and formerly the Coast and Geodetic Survey), the U.S. Public Health Service, or was under binding written agreement to become such a member. (Includes a Soldier who was a Service Academy or ROTC contracted cadet or a member of an Armed Force of another country on that date.)(Note: Concerns the exclusion from federal gross income disability severance pay or the amount of disability retired pay equal to the disability rating x retired pay base)

6 Enclosure 3