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2.7 Medical discharges and ADF Medical Boards
A medical discharge is an involuntary termination of the person's employment by the ADF on the grounds of permanent or at least long-term unfitness to serve, or unfitness for operational deployment.
Involuntary medical discharges from the ADF are made on the recommendation of a Medical Employment Classification Review Board (MECRB) which examines the member and also examines his/her medical record for the purposes of determining whether he/she is incapacitated in the long term, for Defence service. Following a recommendation to medically discharge a person that member has the opportunity to appeal that decision, and to provide reasons why he/she should not be discharged. This is an administrative matter involving only the person and the Department of Defence.
2.7.1 ADF Medical Employment Classification Scheme (MECS)
Involuntary medical discharges are mediated by the ADF's medical classification system.
The ADF Medical Employment Classification (MEC) has the following levels:
126.96.36.199 MEC 1. Fully Employable and Deployable
Medically fit without restriction for deployment or seagoing service for the military occupation specified in the individual case. Personnel classified as MEC 1 are eligible for the full range of posting and service opportunities.
Note: Initial entry to the ADF is at MEC 1 only although a re-enlistment or cross-service transfer (i.e. Army to Air Force) may be at MEC 2.
188.8.131.52 MEC 2: Employable and Deployable with Restrictions
Medically fit for deployment or seagoing service but with:
limitations on the range of duties able to be performed;
geographic restrictions (for instance unable to serve in tropics etc.); and/or
a requirement for access to various levels of health support.
Personnel who are classified as MEC 2 may continue to serve. They are eligible for a range of posting and deployments applicable to their military occupation within their defined employment restrictions. Inter and intra-service transferees and personnel reallocated to another occupation or those re-enlisting in the ADF may be MEC 2.
184.108.40.206 MEC 3: Rehabilitation
All MEC 3 sub-classifications are defined as not fit for operational deployment. MEC 3 is for those medical conditions or injuries that are considered temporary and for which there is a reasonable expectation that the Defence member will return to a deployable status following a period of rehabilitation and recovery. Defence members allocated MEC 3 may be fit for specified field activities and for seagoing activities in accordance with individual rehabilitation programs as defined by the designated single-Service Medical Officer (MO), or delegate, in accordance with relevant health policy.
220.127.116.11 MEC 4: Employment Transition
MEC 4 is designated as an employment transition category that provides several options for the medium-term employment of Defence members who are no longer fully employable in their current employment group. Individual placement will be determined primarily by workforce planning and management considerations. A placement in a MEC 4 may result in:
transition to a deployable MEC;
transition to an alternate employment group; or
a period of limited employment, based on Service requirements, prior to transition from the ADF.
18.104.22.168 MEC 5: Medically Unfit for Further Service
The MEC 5 sub-classifications are:
•MEC J51- Not Employable on Medical Grounds—Medically unfit and not employable other than within applicable restrictions in the period leading up to termination.
•MEC J52- Not Employable on Medical Grounds—Non-effective and unable to be employed in the period leading up to termination.
22.214.171.124 MUFS - Medically Unfit for Further Service
The term 'Medically Unfit for Further Service' (MUFS) is no longer an official category although delegates may find the ADF medical and discharge papers relating to most old medical discharge cases will use this term or variations of it. MUFS has generally been supplanted by the use of 'MEC5' to denote an ADF member who has or will be medically discharged.
126.96.36.199 BMS - Below Medical Standard
'Below Medical Standard' (BMS) is now an obsolete term and is found only in old cases. During the period of its currency, it meant a mild, a partial or a temporary state of incapacity for a particular military employment and was equivalent to the present MEC2 or MEC3. The term BMS has never 'officially' indicated a fitness category requiring involuntary medical discharge from the ADF.
Nevertheless, there are inconsistencies and some of the older medical documents use 'BMS' and 'MUFS' interchangeably.
2.7.2 Significance of an involuntary medical (MEC5) discharge
A person who has been medically discharged is, virtually by definition, incapacitated for (defence) service. However, not all persons who have been medically discharged are incapacitated for (civilian) work.
The ADF requires, as a condition of continued employment, high standards of personal physical fitness and functional ability from its members. ADF members must be capable of deployment to operational service and to reliably perform physically and mentally demanding tasks under combat conditions, in locations where there may be no medical support for an ongoing condition. An injured member may therefore be medically discharged from the ADF for a failure to meet the high fitness and health standards for deployment, yet still be capable of earning an income in suitable civilian work. This is because civilian work does not require combat readiness or the ability to serve in a war zone.
Nevertheless and regardless of the residual capacity for civilian work, a medical discharge provides a medical opinion that the person is incapacitated for the full range of requirements of Defence service.
2.7.3 Entitlement immediately following medical (MEC 5) discharge
On the basis of the loss of Commonwealth employment due to the medical discharge, it is policy to accept the MECRB decision for medical discharge (that is related to an accepted service injury or disease) as medical certification of up to four weeks incapacity, from the date of discharge.
However this ‘default’ authorisation of payment does not extend beyond the start-date of any civilian employment commenced during that same four week period.
Important note: Following this four week period, the person must, if payments are to continue, produce further medical certificates from their treating doctors, to demonstrate continuing incapacity for civilian work or be participating in a vocational rehabilitation plan.
The Separation Health Examination (SHE), listing medical conditions, should be used as evidence, in conjunction with the actual MECRB decision, bearing in mind that a MECRB decision may be made several months prior to the actual date of discharge.
Delegates should not approach Defence to request that a MECRB decision be amended to include accepted disabilities.
The MECRB decision and minutes represent the formal determination by Defence of the reason for a person’s medical discharge and incapacity for service, and should be preferred to a Separation Health Examination or DM042 completed by an LMO when considering eligibility.
2.7.4 Discharges 'Below Medical Standard' (BMS)
The presumption should not be made that a member discharged as BMS ('Below Medical Standard') is entitled to incapacity compensation. Medical and other evidence should be collected before approving compensation for incapacity.
Note however, that cases do occur (primarily older discharges) where the circumstances of a BMS discharge are indistinguishable from those of a MUFS discharge. In such cases, the person is treated as though they have been medically discharged.
2.7.5 Injured recruits discharged with category 'Untrainable'
Recruits are sometimes discharged before completing recruit training with a classification of 'Untrainable', i.e. rather than MEC5.
'Untrainable' covers a wide range of situations, including non-medical or non compensable factors such as lack of aptitude etc. and in general, no presumption should be made that a member discharged as 'Untrainable' is entitled to incapacity compensation.
However in some cases the circumstances of an 'Untrainable' discharge are almost indistinguishable from a medical discharge. For instance:
a recruit sustains relatively minor compensable injuries during recruit training and these are expected to eventually resolve completely
although expected to make a full recovery, the enforced inactivity and/or inability to participate in the program will be protracted enough so that the recruit will be unable to complete the training course
rather than disrupt the recruit training process until the recruit's medical situation is stabilised, he or she is discharged as 'untrainable'.
A discharge classification of ‘Untrainable’ allows the recruit to rejoin once the medical rehabilitation process is complete, whereas a MEC 5 classification infers a permanent unfitness for service and may prevent re-enlistment.
In these circumstances, these persons should be afforded the same four week period of payment before further medical certification is required, as is provided to those being medically discharged.
Delegates should distinguish between the claims of those discharged as ‘Untrainable’ for compensable medical reasons and others also being discharged with the same description/category, but for other and non-compensable reasons (such as lack of aptitude, pre-existing conditions etc.). Only those discharging due to the effects of compensable injuries are eligible for the four week period of incapacity payments before further medical certification is required.