Soldiers are referred into the PDES by five ways:
1. Medical Evaluation Board (MEB)
The medical treatment facility (MTF such as Bayne Jones Army Community Center) initiates a MEB under the provisions of AR 40-400, chapter 7, when a soldier has received maximum benefit of medical care for a condition which may render the soldier unfit for further military service. (Per DoDI 1332.38, soldiers shall be referred for evaluation within one year of the diagnosis of their medical condition if they are unable to return to military duty.) The MEB documents whether the soldier meets the medical retention standards of AR 40-501, chapter 3. If the soldier does not meet medical retention standards, the MTF refers the case to the applicable Physical Evaluation Board (PEB) for a determination of fitness under the policies and procedures of DoD Instruction 1332.38 and AR 635-40.
2. MOS/Medical Retention Board (MMRB)
The MMRB is an administrative screening board conducted under the provisions of AR 600-60 that determines whether soldiers with permanent 3 or 4 physical profiles can physically perform their primary military occupational specialty (branch/specialty code for officers) in a worldwide, field environment. Referral to a Medical Evaluation Board/Physical Evaluation Board is one of four actions the MMRB Convening Authority (MMRBCA) may direct. When the MMRBCA directs referral to a MEB/PEB, conduct of the PEB is normally mandatory without regard to the findings of the MEB. The MEB may only return the soldier to duty when it determines the soldier meets medical retention standards and upgrades the profile to a permanent 2 or 1.
3. Fitness for Duty Medical Examination
Commanders may refer soldiers under their command to the MTF for a medical examination under the provisions of AR 600-20, para 5-4, when they believe the soldier is unable to perform MOS or specialty code duties due to a medical condition. This examination may cause conduct of a Medical Evaluation Board, which normally will be forwarded to the Physical Evaluation Board when it finds that the soldier's medical condition falls below medical retention standards.
4. HQDA action
The Commander, HRC, upon recommendation of The Surgeon General, may refer a soldier to the responsible Military Treatment Facility (Bayne Jones Army Community Center) for medical evaluation as described in #3 above. The Commander, PERSCOM, may direct referral into the Physical Disability Evaluation System when it disapproves an MMRB recommendation to reclassify a soldier (or branch transfer an officer).
5. RC Non-duty Related Process
DoD Directive 1332.18, as implemented by DoDI 1332.38, affords RC members pending separation for medical disqualification (separation for failure to meet medical retention standards) the right to be referred to a PEB for solely a fitness determination. Referral is not mandatory but at the request of the soldier. These cases pertain to RC Active Status soldiers not on extended active duty whose disqualifying medical impairments were incurred outside of military service and involve no issue of aggravation while in a duty status. Referral to the PEB allows these soldiers to have fitness determined under the standards applied to Active Army soldiers and RC soldiers with service-incurred conditions (see below). The USAR Regional Support Command or the ARNG State Headquarters refers the case to the PEB—not the MTF. The MTF may conduct a physical on the soldier at the request of the RC, but does not conduct a MEB.