The U.S. Navy is eliminating its automatic 180-day limited-duty period for injured or ill sailors and Marines and moving to a flexible time frame based on a service member's medical diagnosis and projected recovery time.
The service also will introduce a position at Navy Medical Training Command and major units dedicated to monitoring and facilitating the process -- physicians fully versed in medical evaluation policies, diagnoses and treatments who can advise leaders on the status of personnel on limited duty and weigh in on return-to-duty decisions.
The changes, Navy officials say, will improve readiness by ensuring that sailors and Marines have the time needed for treatment and recovery -- and by helping guide expectations at the command level.
"Every sailor is a unique situation. They are all going to be very different, very unique. So we have the changes here that help us focus to get the sailors to full recovery, to help get them back to the fleet and do the job they signed up to do," Capt. Marc Franzos, director of medical readiness, said Monday.
Currently, sailors and Marines diagnosed with an illness or who sustain an injury that renders them unable to do their jobs are placed on an automatic 180-day limited-duty period, which Franzos said is too long for some conditions and not long enough for others.
For example, knee pain caused by tendonitis may need an 8- to 12-week recovery period with physical therapy, while a torn anterior cruciate ligament -- one of the most common injuries sustained by service members -- could take up to 15 months from diagnosis through surgery and recovery.
Navy data shows that the largest tranche of limited-duty cases from 2017 to 2020 were closed at 180 days, followed by a spike at day 360, with very few people coming off limited duty during the months in-between.
"We found, when talking earnestly with my colleagues in ... Navy Medicine, that they were often approaching this period of limited duty as an entitlement, a precious entitlement that if you don't use the full time, you are short-changing the individual," Franzos said.
The new plan is for medical providers to recommend a limited-duty period at the start of a diagnosis based on the known recovery time for the condition.
In the Navy, if a physician determines that treatment and recovery will take more than a year, the sailor will apply for a waiver to the service's requirement that they be deployable within 12 months or face discharge.
The Marine Corps has decided Marines must show that they are making progress toward recovery; if their recovery is expected to take more than a year, they will apply for a waiver at the 8- to 10-month mark.
The timeline will begin once the member is entered into the Limited Sailor and Marine Readiness Tracking System. Once that action occurs, the deployability assessment and assignment branch is to take action to ensure that sailors on operational platforms are reassigned to shore commands; their personnel rotation dates are adjusted as needed; and their records are flagged so detailers know to take appropriate action.
Once a service member returns to duty, the process is reversed.
Helping guide individuals and commands through the new process will be the medical evaluation board approving authority, or MEBAA -- a senior physician whose sole job is to serve as a functional expert on the service member's oversight team. They can represent the command in the process, if he or she is a uniformed person or -- more likely, Franzos said -- a civilian Department of the Navy employee.
The MEBAA can advise leadership and sailors on limited-duty and retention decisions, as well as disability evaluation recommendations.
In addition, the Navy plans to hire coordinators to ensure that sailors and Marines get to their medical appointments and their multidisciplinary support team is ready for their monthly case reviews.
For complex medical cases such as cancer, sailors and Marines also will have a case manager to assist them with "meeting their medical gates."
"It's a very sophisticated process to ensure that we're maximizing the focus on recovery and accelerating the return to duty in the service," Franzos said.
According to Franzos, the Navy is meeting the Department of Defense's goal of having less than 5% of the force on limited duty or in non-deployable status.
He didn't provide the exact number of personnel on limited-duty status but said the new system could reduce those numbers further.
"Bottom line is we have kept the goal overall for non-deployability at less than 5%, which is made up largely by the limited-duty population," Franzos said.
Navy officials said the new policy is in place and they are starting to train medical personnel and other responsible parties on the changes.
The new system, Franzos said, will give everyone involved a clearer idea of what to expect when a sailor or Marine is put on limited duty.
"This may help service members strive to hit those treatment goals, as well as to give the providers a clear expectation at the outset that they can describe to their patients. That's the one of the biggest selling points," he said.