E2.1.22. Optimum Hospital and Medical Treatment Benefits. The point of hospitalization or
treatment when a member's progress appears to be stabilized; or when, following administration
of essential initial medical treatment, the patient's medical prognosis for being capable of
performing further duty can be determined.
E2.1.25. Physical Disability. Any impairment due to disease or injury, regardless of degree,
that reduces or prevents an individual's actual or presumed ability to engage in gainful
employment or normal activity. The term "physical disability" includes mental disease, but not
such inherent defects as behavioral disorders, adjustment disorders, personality disorders, and
primary mental deficiencies. A medical impairment or physical defect standing alone does not
constitute a physical disability. To constitute a physical disability, the medical impairment or
physical defect must be of such a nature and degree of severity as to interfere with the member’s
ability to adequately perform his or her duties.
E4.1. GENERAL
E4.1.1. This enclosure provides a listing, mainly by body system, of medical conditions and
physical defects which are cause for referral into the Disability Evaluation System (DES).
E4.1.1.1. This listing is not all inclusive.
E4.1.1.2. A service member who has one or more of the listed conditions or physical
defects is not automatically unfit and therefore may not qualify for separation or retirement for
disability.
E4.1.2. Individual Secretaries of the Military Departments may, consistent with this
Instruction, modify these guidelines to fit their particular needs. These modifications may
include conditions or defects, individually or in combination that:
E4.1.2.1. Significantly interfere with the reasonable fulfillment of the purpose of the
individual's employment in the Military Service;
E4.1.2.2. May seriously compromise the health or well-being of the individual if he or
she were to remain in the Military Service. This may involve dependence on certain
medications, appliances, severe dietary restrictions, or frequent special treatments, or a
requirement for frequent clinical monitoring.
E4.1.2.3. May prejudice the best interests of the Government if the individual were to
remain in the Military Service.
E4.1.3. Any condition that appears to significantly interfere with performance of duties
appropriate to a service member's, office, grade, rank or rating will be considered for MEB
evaluation.
E4.2.3. Inflammatory Condition. Any inflammatory condition involving the bones, joints,
or muscles of the extremities, that after accepted therapy, prevents the military member from
performing the preponderance of duties assigned.
E4.2.7.2.2. Spondylolysis and/or Spondylolisthesis requiring fusion with loss of
mobility.