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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 (MEC)
Involuntary medical discharges are mediated by the ADF's medical classification system. The ADF Medical Employment Classification (MEC) has the following levels:
J11 Fully Employable and Deployable - No Restriction/ No Requirement
J12 Fully Employable and Deployable - No Restriction/Some Requirement
J21 Restricted Deployment - Defined Limitations
J22 Restricted Deployment - Defined Limitations and/or Required Materiel Support
J23 Restricted Deployment - Defined Limitations and/or Required Materiel Support and Defined Access to Health Facility
J29 Limited Deployment - MECRB assigned only - Defined Limitations and/or Required Materiel Support and Defined Access to Role 2E Health Support
J32 Extended Rehabilitation - MECRB assigned only
J34 Temporarily Non-Effective
J40 Holding - pending MECRB determination
J41 Alternate Employment - MECRB assigned only
J42 Employment at Service Discretion - MECRB assigned only - Duration up to five years at any one time
J44 Extended Non-Effective - MECRB assigned only - Not fit for work for a defined period
J51 Not Employable on Medical Grounds - Medically Unfit
J52 Not employable on Medical Grounds - Non Effective
J53 Extended transition - Duration up to three years to support separation from the ADF on medical grounds - MECRB assigned only.
L27 Land Environment - Limited Deployment - MECRB assigned only
L28 Land Environment - Limited Deployment - MECRB assigned only
M24 Maritime Environment - Defined Limitations and/or Required Materiel Support
M25 Maritime Environment - Defined Limitations and/or Required Materiel Support - and/or Access to Health Support
M26 Maritime Environment - Defined Limitations and/or Required Materiel Support and/or Access to Health Support (FMO endorsed only)
2.7.2 Significance of an involuntary medical (J51 - J53) 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 (J51 - J 53) 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 twelve 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 twelve week period.
Important note: Following this 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) and Medically Unfit for Further Service (MUFS)
'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. 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.
The presumption should not be made that a member discharged 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.
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 been replaced by the current MEC to denote an ADF member who has or will be medically discharged.