Military Disability Retirement: Closer Monitoring Would Improve the Temporary Retirement Process Page: 70 of 89
This report is part of the collection entitled: Government Accountability Office Reports and was provided to UNT Digital Library by the UNT Libraries Government Documents Department.
Extracted Text
The following text was automatically extracted from the image on this page using optical character recognition software:
Appendix V: Sample Air Force Form:
Findings and Recommendations of the USAF
Physical Evaluation Board (AF Form 356)DATE
X INFORMAL FNIDINGS AND RECOIMENIhDED I)SI)STION OF
USAF PHYSICAL EVALUATION BO.RD
YORMAI.
1. TiE BOARD CONVENED AT Randolph AF TX 781 504708 PER ATTACHED ORDERS (E.!IIBFTA)
2 A QUJRUMl WAS PRESENT AS INIDICA Fr-) ON ]XHfBT I A 3_ EX-IH IS AlI-ACHEI): A, H.
4. MEM-.ERS NAME Ilis. Fin. Aliiddtn liuiiida 5. (OAI)E 6. SSN 7. YEAS OF SERV[CKE I. COMPONENT
UNDER 10 USC 12OS X REC AF
USAFR
ANG
9. FINDINGS CONCERNING INDIVIDUAL DEFECTS OR CONDITIONS
CotUMN A, Include degree ofsverity
COLUMN C- Enter "YES" for in line ofldty, 'M for intentioal misconduct. "N" for H
wilful neglect, "A" For incurred during a period of urnthorized abence, or
"NA".
COLUMNS H and dD- iEnter "YES", "NO", or "NA". I
COLUMNS E and F - Self-explanatory.
A. iJAGNOSR H. C. 0. 1. F.
CATEGORY I - UNTITTING CONDITIONS WHICH ARE
COMPENSABLE ANDT RATABLE:
NONE
CURRENT RATING 00
.IESS AGGRAVATING/CONTRII IO F)RY FAC IORS -M0
COMBINED RATING D0
CATEGORY TI - CONDITIONS THAT CAN BE UNFITTING BUT
ARE NOT CURRENTLY COMPENSABILE OR RATABLE:
NONE
CATEGORY III - CONDITIONS THAT ARE NOT SEPAIKTELY
UNFITTING AND NOT COMPENSABLE OR RATABLE:
NONE
tl._ AD)[)T]ONAL. FIN)]NGS YES NO NA
A. MEMBERS LUNf['T HEC'ALJE 3F POFHYS]CAL[. )ISAIL[.LI'Y X
R. DISARTITY W AS INCRRED I IE OF DUT I I OF DUTY IN M OF WAR R OR NATIONAL EMERGENCY OR AFTER X
14 SEPTEMBER 1978
C. DISABILITY WAS TIIE DIRECT RESULT OF ARMED CONFLICT OR WAS CAUSEDBY AN INSTRUMENTALITY OF X
WAR AND 1N'URRLED IN L1NE OF DUTY DURING A PERIOD OF WAR
D. DISABILITY WAS TIlE DIRECT RESULT OF A COMBAT RELATED INJURY X
E. DEGREE OF IMPAIRMENT IS MAYBE PERMANENT
]. COME NSA 1E PERCENTAGE ]2. REC M MENDE):) DISPOSITION
3. OVERCOMES PRESUMPTION OF FITNESS 14. SIGNATURE OF PEB PRESIDENT OR PEB REPRESENTATIVE
YES NO 1 NA
SEPARAnION E RENIEN'T DATE
15. REMARKS
CLINICS FOR TIDRL IiVA LUATIONS
NAAF Form 356, OCT 95 PREvooIs rmN is OBSo nm
GAO-09-289 Military Temporary Retirement
Page 64
Upcoming Pages
Here’s what’s next.
Search Inside
This report can be searched. Note: Results may vary based on the legibility of text within the document.
Tools / Downloads
Get a copy of this page or view the extracted text.
Citing and Sharing
Basic information for referencing this web page. We also provide extended guidance on usage rights, references, copying or embedding.
Reference the current page of this Report.
United States. Government Accountability Office. Military Disability Retirement: Closer Monitoring Would Improve the Temporary Retirement Process, report, April 13, 2009; Washington D.C.. (https://digital.library.unt.edu/ark:/67531/metadc297891/m1/70/: accessed May 16, 2024), University of North Texas Libraries, UNT Digital Library, https://digital.library.unt.edu; crediting UNT Libraries Government Documents Department.