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Standards of Medical Fitness Army Regulation 40–501 Medical Services Standards of Medical Fitness Rapid Action Revision (RAR) Issue Date: 23 August 2010 Headquarters Department of the Army Washington, DC 14 December 2007 UNCLASSIFIED SUMMARY of CHANGE AR 40–501 Standards of Medical Fitness This rapid action revision, dated 23 August 2010-- o Clarifies waiver authorities for officer accessions and commissions for the U.S. Military Academy, Reserve Officers’ Training Corps, and Officer Candidate School (paras 1-6c and 1-6e). o Updates the medical retention standards for psychiatric disorders and hearing (paras 3-10 and 3-31). o Adds a requirement for referral to a Medical Evaluation Board for rhabdomyolysis (para 3-40). o Provides new definitions for heat illness and reasons for a Medical Evaluation Board (para 3-45). o Clarifies who has ultimate responsibility to determine whether to deploy a Soldier (para 5-14d, 5-14e, and 5-14f). o Updates deployment-limiting psychiatric medical conditions (para 5-14f(8)). o Updates functional activities to reflect content changes to DA Form 3349, Physical Profile (chap 7). o Requires review of all permanent 3 and 4 profiles by a Medical Evaluation Board physician or other physician approval authority (para 7-4b). o Establishes and defines the term Medical Retention Determination Point (para 7-4b(2)). o Allows physician assistants, nurse practitioners, and nurse midwives to write permanent profiles as the profiling officer (para 7-6a(4)). o Changes administrative code designations for physical profiles (table 7-2). o Adds psychiatric evaluations for certain administrative separations (paras 8-24a(1) and 8-24a(2)). o Changes references from non-deployable or not available to medically not ready (para 11-4). o Updates glossary and references (app A). o Makes additional rapid action revision changes (throughout). Headquarters *Army Regulation 40–501 Department of the Army Washington, DC 14 December 2007 Effective 14 January 2008 Medical Services Standards of Medical Fitness otherwise stated. It also applies to candi- Army management control process. dates for military service. During mobili- This regulation contains management con- z a t i o n , t h e p r o p o n e n t m a y m o d i f y trol provisions and identifies key manage- c h a p t e r s a n d p o l i c i e s c o n t a i n e d i n t h i s ment controls that must be evaluated (see regulation. appendix B). Proponent and exception authority. S u p p l e m e n t a t i o n . S u p p l e m e n t a t i o n o f The proponent of this regulation is The this regulation and establishment of com- Surgeon General. The proponent has the mand and local forms are prohibited with- authority to approve exceptions or waivers o u t p r i o r a p p r o v a l f r o m T h e S u r g e o n to this regulation that are consistent with General (DASG–HS–AS), 5109 Leesburg controlling law and regulations. The pro- Pike, Falls Church, VA 22041–3258. ponent may delegate this approval author- ity, in writing, to a division chief within Suggested improvements. Users are the proponent agency or its direct report- invited to send comments and suggested ing unit or field operating agency, in the improvements on DA Form 2028 (Recom- History. This publication is a rapid action grade of colonel or the civilian equivalent. m e n d e d C h a n g e s t o P u b l i c a t i o n s a n d revision (RAR). This RAR is effective 23 Activities may request a waiver to this Blank Forms) directly to the Office of September 2010. The portions affected by regulation by providing justification that T h e S u r g e o n G e n e r a l ( D A S G – H S – A S ) , t h i s R A R a r e l i s t e d i n t h e s u m m a r y o f includes a full analysis of the expected 5109 Leesburg Pike, Falls Church, VA change. benefits and must include formal review 22041–3258. Summary. This publication implements by the activities senior legal officer. All Distribution. This publication is availa- D O D D 6 1 3 0 . 3 a n d D O D I 6 1 3 0 . 4 . I t waiver requests will be endorsed by the ble in electronic media only and is in- provides information on medical fitness commander or senior leader of the requ- s t a n d a r d s f o r i n d u c t i o n , e n l i s t m e n t , a p - tended for command levels A, B, C, D, e s t i n g a c t i v i t y a n d f o r w a r d e d t h r o u g h and E for medical activities only of the pointment, retention, and related policies t h e i r h i g h e r h e a d q u a r t e r s t o t h e p o l i c y and procedures. Active Army, the Army National Guard/ proponent. Refer to AR 25–30 for specific A r m y N a t i o n a l G u a r d o f t h e U n i t e d Applicability. This regulation applies to guidance. States, and the U.S. Army Reserve. t h e A c t i v e A r m y , t h e A r m y N a t i o n a l Guard/Army National Guard of the United States, and the U.S. Army Reserve, unless Contents (Listed by paragraph and page number) Chapter 1 General Provisions, page 1 Purpose • 1–1, page 1 References • 1–2, page 1 Explanation of abbreviations and terms • 1–3, page 1 Responsibilities • 1–4, page 1 Medical classification • 1–5, page 1 Review authorities and waivers • 1–6, page 1 Chapter 2 Physical Standards for Enlistment, Appointment, and Induction, page 2 General • 2–1, page 2 *This regulation supersedes AR 40–501, dated 14 December 2007. This edition publishes a rapid action revision of AR 40–501. AR 40–501 • 14 December 2007/RAR 23 August 2010 i UNCLASSIFIED Contents—Continued Application and responsibilities • 2–2, page 2 Abdominal organs and gastrointestinal system • 2–3, page 4 Blood and blood-forming tissue diseases • 2–4, page 5 Dental • 2–5, page 5 Ears • 2–6, page 5 Hearing • 2–7, page 5 Endocrine and metabolic disorders • 2–8, page 6 Upper extremities • 2–9, page 6 Lower extremities • 2–10, page 7 Miscellaneous conditions of the extremities • 2–11, page 7 Eyes • 2–12, page 8 Vision • 2–13, page 9 Genitalia • 2–14, page 10 Urinary system • 2–15, page 11 Head • 2–16, page 11 Neck • 2–17, page 11 Heart • 2–18, page 11 Vascular system • 2–19, page 12 Height • 2–20, page 12 Weight • 2–21, page 12 Body build • 2–22, page 12 Lungs, chest wall, pleura, and mediastinum • 2–23, page 12 Mouth • 2–24, page 13 Nose, sinuses, and larynx • 2–25, page 13 Neurological disorders • 2–26, page 13 Learning, psychiatric and behavioral disorders • 2–27, page 14 Skin and cellular tissues • 2–28, page 15 Spine and sacroiliac joints • 2–29, page 16 Systemic diseases • 2–30, page 17 Tumors and malignant diseases • 2–31, page 17 General and miscellaneous conditions and defects • 2–32, page 18 Chapter 3 Medical Fitness Standards for Retention and Separation, Including Retirement, page 20 General • 3–1, page 20 Application • 3–2, page 21 Disposition • 3–3, page 21 General policy • 3–4, page 21 Abdominal and gastrointestinal defects and diseases • 3–5, page 21 Gastrointestinal and abdominal surgery • 3–6, page 22 Blood and blood-forming tissue diseases • 3–7, page 22 Dental diseases and abnormalities of the jaws • 3–8, page 23 Ears • 3–9, page 23 Hearing • 3–10, page 23 Endocrine and metabolic disorders • 3–11, page 23 Upper extremities • 3–12, page 24 Lower extremities • 3–13, page 24 Miscellaneous conditions of the extremities • 3–14, page 25 Eyes • 3–15, page 25 Vision • 3–16, page 26 Genitourinary system • 3–17, page 26 Genitourinary and gynecological surgery • 3–18, page 27 Head • 3–19, page 27 Neck • 3–20, page 27 Heart • 3–21, page 27 ii AR 40–501 • 14 December 2007 Contents—Continued Vascular system • 3–22, page 28 Miscellaneous cardiovascular conditions • 3–23, page 29 Surgery and other invasive procedures involving the heart, pericardium, or vascular system • 3–24, page 29 Trial of duty and profiling for cardiovascular conditions • 3–25, page 29 Tuberculosis, pulmonary • 3–26, page 30 Miscellaneous respiratory disorders • 3–27, page 30 Surgery of the lungs • 3–28, page 31 Mouth, esophagus, nose, pharynx, larynx, and trachea • 3–29, page 31 Neurological disorders • 3–30, page 31 Disorders with psychotic features • 3–31, page 32 Mood disorders • 3–32, page 32 Anxiety, somatoform, or dissociative disorders • 3–33, page 32 Dementia and other cognitive disorders due to general medical condition • 3–34, page 33 Personality, psychosexual conditions, transsexual, gender identity, exhibitionism, transvestism, voyeurism, other paraphilias, or factitious disorders; disorders of impulse control not elsewhere classified • 3–35, page 33 Adjustment disorders • 3–36, page 33 Eating disorders • 3–37, page 33 Skin and cellular tissues • 3–38, page 33 Spine, scapulae, ribs, and sacroiliac joints • 3–39, page 34 Systemic diseases • 3–40, page 34 General and miscellaneous conditions and defects • 3–41, page 35 Malignant neoplasms • 3–42, page 36 Benign neoplasms • 3–43, page 36 Sexually transmitted diseases • 3–44, page 36 Exertional heat illness • 3–45, page 36 Cold injury • 3–46, page 37 Chapter 4 Medical Fitness Standards for Flying Duty, page 40 General • 4–1, page 40 Classes of medical standards for flying and applicability • 4–2, page 40 Aeromedical consultation • 4–3, page 41 Abdomen and gastrointestinal system • 4–4, page 41 Blood and blood–forming tissue diseases • 4–5, page 41 Dental • 4–6, page 41 Ears • 4–7, page 42 Hearing • 4–8, page 42 Endocrine and metabolic diseases • 4–9, page 42 Extremities • 4–10, page 42 Eyes • 4–11, page 42 Vision • 4–12, page 43 Genitourinary • 4–13, page 44 Head and neck • 4–14, page 44 Heart and vascular system • 4–15, page 44 Linear anthropometric dimensions • 4–16, page 45 Weight and body build • 4–17, page 45 Lung
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