# Medical Chits



## spr_sldr (25 Nov 2007)

I've been talking to some of the guys in my unit about medical chits and using other kit. Before I looked into it more I wanted to ask on here.
I'm looking to get a Jump Ruck, my buddy got one and I used it on an exercise, and instead of the next day my back being FUBAR I could move my neck and back around fine. My issue ruck used to be fine, but I worked at a stone quarry this summer and pulled a muscle in my back, and to begin with I've always had back problems but that didnt make it any better.
How do I go about getting a medical chit for this? Is it possible? Thanx.


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## PuckChaser (25 Nov 2007)

Its a little more difficult since you're a reservist, and not entitled to a lot of medical care (especially since your injury was caused outside military time). I guess by asking on the forum, you haven't gotten permission from your unit to just buy one (at your own expense) and wear it, so that idea is out.

Basically, you'll need to be on Cl B for the summer, show up at the MIR for sick parade, and try to get refered to physio where they can write you a chit.


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## spr_sldr (25 Nov 2007)

thats what i was afraid of, o well, ill pass it up the chain of command and see what i can get.
there are alot of guys in the unit that use them, and have stuff like SWAT boots and the chits to go with it, so i know it can be done, i juts thought id ask on here.


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## The_Falcon (25 Nov 2007)

You could also try using the search function.  There are quite few threads out there.


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## riggermade (25 Nov 2007)

What I would do is check with the unit on the policy.  There are many units out there who do not have a problem with pers using 64 pattern ruck and alot of units don't require med chits.  It will cost you to buy one as there aren't any in the system except at the jump companies.  Check prices as there is quite the variation out there.  PM me if you need any info


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## Armymedic (25 Nov 2007)

Buy a frame and mount the issued ruck on it.


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## Shamrock (25 Nov 2007)

My wife uses that set-up for a different reason -- she's too short for the '82.  I've tried it once or twice and have noticed no difference.  Same heavy load, same distance.  Same suck.

I know a few people who claim miracles have occured after swapping frames.  No more lower back pain, no more knee pain, ability to play violin, etc.  However,  I have to wonder how much of it is kititis or placebo effect.


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## riggermade (25 Nov 2007)

If you have better pads with the bag and frame there is a difference.  Can't be a placebo effect for everybody that uses it and there are alot


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## John7771796 (23 Apr 2015)

Hi, long time reading, first time posting.

Just having a quick question and I couldn't find the answer on here:
I got injured 2 days ago while doing unit PT, and received a 30 days MEL at the MIR. I am supposed to go on a trade qualification course next week and I know I won't be able to do anything over there with my injury, course is physically demanding. My CoC still want to send me on course, so I would like to know if there is anything I can do to remove my name from the course loading list. My concern is that I will piss the staff off when I show up with a medical chit and end up being recourse anyway with a bad course report. Any policies in the CF for that situation? 

Thanks.


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## DAA (23 Apr 2015)

John7771796 said:
			
		

> Hi, long time reading, first time posting.
> 
> Just having a quick question and I couldn't find the answer on here:
> I got injured 2 days ago while doing unit PT, and received a 30 days MEL at the MIR. I am supposed to go on a trade qualification course next week and I know I won't be able to do anything over there with my injury, course is physically demanding. My CoC still want to send me on course, so I would like to know if there is anything I can do to remove my name from the course loading list. My concern is that I will piss the staff off when I show up with a medical chit and end up being recourse anyway with a bad course report. Any policies in the CF for that situation?
> ...



If you think the injury will "definitely" prevent you from completing all of the required training, then just return to your MIR and ask to have your current chit amended to read "Unfit occupational training courses".

That's the simple solution.

In reality and seeing as your CoC is already aware of the MEL's, they should contact the training agency who is going to conduct the training and find out if your MEL's are an impediment.


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## PMedMoe (23 Apr 2015)

DAA said:
			
		

> In reality and seeing as your CoC is already aware of the MEL's, they should contact the training agency who is going to conduct the training and find out if your MEL's are an impediment.



I was wondering if there might be anything on the joining instructions stating the member must be physically fit?


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## Messorius (23 Apr 2015)

PMedMoe said:
			
		

> I was wondering if there might be anything on the joining instructions stating the member must be physically fit?



If it's the same across the board, all of mine have had mentally/dentally/physically fit as a requirement(LFAAD 5.2.6).


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## Nfld Sapper (23 Apr 2015)

I think all CTP'S state member must be medical fit but usually have a disclaimer like this one from the now defunct Engr Recce SGT - OPS NCO course:



> MEDICAL CONSIDERATIONS
> 17. Units sending students for training are responsible for ensuring that their members are fit to attend course upon arrival at CFSME. If a member has any medical restrictions (i.e., light duties, Medical Employment Limitations (MELs), temporary or permanent medical category, etc.) the home unit must confirm with their medical staff that the member is capable of completing all tasks associated with the training they will be participating in. In many cases, this will involve additional discussion with medical staff to ensure they understand the physical requirements associated with specific training tasks. A detailed list of the tasks for each course is available in the course Training Plan and any questions regarding the exact nature of a task can be directed through the CFSME Adjutant.


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## vincent.escanlar (23 Apr 2015)

When I would assess a student's MELs I found it helpful when DS would provide some description of what the course entails, eg:



> Memorandum
> 
> 1000-1 (1 Pl Comd)
> 
> ...



Of course we would/should avoid writing vague MELs like "unfit training", so having some idea of what the course entails helps ensure the MELs are specific and gives student and DS every opportunity to train within the bounds of what's medically-reasonable. It also helps us picture how intense the course is - for example, a recovering student might be able to do a one-off run or ruck, but if it's going to keep adding up without opportunity for rest, I think that also needs to be part of the MEL thought process.

 Ideally we medical staff would get lots of opportunity to go to the training area and see for ourselves what happens; if not, I found a description like this would be the next best thing.


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## simardg (12 Aug 2015)

Hi everyone! 
I have a small question that i think a few persons might be able to answer because i can't find any to my problem. My Soldier Qualification in Valcartier is starting in less than a month, the 10Th of September to be exact. I went to the MIR for water in my knee, i only wanted to stop for maybe 3 weeks to be able to go on my SQ without any problem and continue my physio, but the doctor gave me a 30 days Chit to give me more time. It means that the Chit will end the 12Th, 2 days after my course is started and my superior can't send me on the course. I tried everything to talk to a doctor or a duty Officer in Borden but i can't have a minute talk with them. I would just like to know if it's possible to change the duration of my medical chit for only 3-4 days or simply cancel it. If i can't cancel it i can say goodbye to my SQ and to the only french Vehicle Technician course that will start this year. My sergeant can't change the medical file and an answer of one of you would be more than grateful.
Thank you very much for your time and sorry for my poor english


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## Lumber (12 Aug 2015)

Only a medical officer can change the conditions on your chit, but yes, with re-evaluation they should be able to change it. 

They won't let you make an appointment?


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## simardg (12 Aug 2015)

The next appointment they can give me would be in more than a week, but my sergeant as to put the name of everyone this week for the course or something like that, this is why i go to the MRI for the sick-parade tomorrow if my staff let me. I think that you answer my question, i heard that the don't re-evaluate medical Chit but i might heard wrong, i just need 2 days less on it. I'll try, thanks again


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## Lumber (12 Aug 2015)

Your staff can't deny you going to sick-parade, nor can they ask you what you went to sick parade for. All they can really ask is if whatever you were seen about will affect your military duties in any way. 

That being said, if they can't change it for you tomorrow you're shit out of luck. Your Sgt and the course staff can't legally ignore your chit and let you on the course because it's "only the last two days". Further, no one can change your medical status, MELs, restrictions, etc. except for a medical doctor.

Good luck.


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## Armymedic (12 Aug 2015)

Lumber said:
			
		

> Only a medical officer can change the conditions on your chit, but yes, with re-evaluation they should be able to change it



Incorrect; any clinician (doctor, physician assistant or nurse practitioner) can change medical limitation AFTER re-evaluation.

The remainder of your points are correct.


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## simardg (12 Aug 2015)

Thank you for your answer, i'll go to the sick parade tomorrow, like you said they can't really stop me if it's for a good reason. My sgt say that if i get hurt the first day of SQ and i'm still on Chit she will get in trouble. So i'm going to tell them i just want to have a shorter Chit to be able to go in my course and that i'll take more physio appointment to be sure to solve my problem, that i didn't know it was like that and that i didn't need 30 days in the end.


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## MedCorps (13 Aug 2015)

This is not an uncommon problem.  Go on sick parade.  Explain your situation to your clinician and they will make a call. Make sure you:

1) know the start and end date of your course, 
2) can provide an honest assessment of how your medical conditions is resolving / not resolving, and 
3) have a plan as to what you are going to do if the conditions returns or gets worse while on course. 


Good luck, 

MC


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## brokendude (1 Dec 2016)

Good morning.  So I was recently placed on a PCAT & granted retention (medically) for 2 years with a 3b release.  My question is....my current chain of command is hounding me about my chit being outdated and no longer current or valid.  Of course not....it expired and I was placed on a Pcat awaiting medical release.  The unit & my chain of command received my disclosure as well as my 2088 form with all medical restrictions placed on me directly related to my Pcat.  Is there any reason why I need to go out of my way and accommodate my chain of command with a medical chit printed off from the cdu?  I don't believe I am required to, but the constant prodding and bs from the chain is really starting to piss me off.  At some point I'm likely going to just tell them to f@ck off. Any suggestions on how to deal with unintelligent nco's?  Thanks in advance.


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## ModlrMike (1 Dec 2016)

Where is your Sgt Maj in this? Have you asked for their help? Where is the OC or Pl Comd?

A copy of your 2088 should be on your pers file. I recommend that you check with your orderly room. If they don't have a copy then point that out, and let them know that a copy can be obtained from the CDU. If they do, then you can respond to your chain that a copy of your current CF2088 and MELs is on your pers file which they can access IAW unit processes.  

That being said, you may find that it's easier to do it yourself. You may be able to ask Med Records for a copy. If they give you grief, then see if you can explain your dilemma to the Clinic WO and they may be disposed to helping you get a copy. It is imperative that you only ask for help getting a copy of the 2088, and that it is clearly understood that is is all you are asking for. Any other intervention would go badly for you.

Finally, your NCOs are more likely uneducated rather than unintelligent. The first does not necessarily equate with the second.


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## captloadie (1 Dec 2016)

A period of retention is approved based on the CoC's recommendation, whereby they say you are still gainfully employable. If you can no longer perform at the required levels (for any number of reasons) or become an administrative burden, they can just as easily request to have your period of retention terminated. Yes your supervisors should be aware of your current MELs, but new people don't always get the handover they require. And there is nothing wrong or unlawful about them asking for a copy of your MELs, they may be truly unaware of where to get the info themselves.


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## Eye In The Sky (2 Dec 2016)

I'd also recommend not telling them to f$$k off.   8)


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## CombatDoc (3 Dec 2016)

Your chain of command is entitled to know your current medical category and MELs. Ask your CDU clerk to print off a copy of your PCAT 2088 and give that to your supervisor. And, what EITS said....


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## CountDC (5 Dec 2016)

me thinks some have lost the OP message or I am misunderstanding him.  The problem is not with the chain of command knowing the MELs, it is them harassing for a new chit which doesn't exist nor should they be looking for one as they are aware the OP is on a PCat. If they want to see the MEL's then there is no reason they can't go to the OR and enquire themselves.  The unit obviously received it as the CO had to sign it and they did a retention.


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## Steve_D (6 Dec 2016)

The "P" in PCAT stands for Permanent. In other words, it does not expire. The only way that it can change is if there was some miraculous, positive change in the member's medical situation.


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## captloadie (9 Dec 2016)

The OPs P-Cat won't change, but his MELs could. And his current MELs may not be on his pers file, as a new 2088 may not have been generated if the MELs aren't changing his category. There is nothing wrong with a supervisor asking for a member's chit that states his most recent MELs, especially if there has been a change from when his PCAT was issued. Maybe the OP has said "sorry, can't do that, I'm on a PCAT". Or maybe he has said "hey, I can do that now, x has gotten better since the PCAT, or I've adjusted to my meds so there are no worries". The supervisors are just doing their due diligence.


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## ModlrMike (9 Dec 2016)

brokendude said:
			
		

> ...about my chit being outdated and no longer current or valid.





			
				captloadie said:
			
		

> The supervisors are just doing their due diligence.



Sorry, I have to side with the member here. He has a PCAT, he would therefore not have a current medical chit. Notwithstanding, I maintain my opinion that this is a situation his WO should be sorting out.


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## Kiwi99 (13 Sep 2017)

Team

I have heard, but never seen the written proof, that the CO of a unit can override a med chit issued from a CDU or Garrison Health Clinic.  Now, I am sure there are parameters and strict guidelines if such a thing exists, therefore it is probably never considered by a CO.  However, if a chit was issued for excused duties by a med tech of Cpl or lower, can the CO override that, forcing a base surgeon to re-examine the issue?

And while I am at it, can a Cpl or lower med tech (even a QL5 med tech) sign off on and issue chits for excused duties?  Seems somewhat odd to me.

I have tried searching for previous threads on this and had no joy


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## medicineman (13 Sep 2017)

https://army.ca/forums/threads/117679/post-1347614.html#msg1347614

This shows the CANFORGEN that I seem to recall from a number of years ago that says that they cannot countermand a medical chit...this may have been up dated, but I have my doubts, since I remember when the current CDS was my CO, he was invited to tea with the then Director General Health Services regarding this very issue.

As for what level Med Tech can issue what level of chit, I found that it varies from unit to unit, but generally a QL5 can give a day or two excused duty...because in most units, unless decreed by the CO, most members can call in sick up to 2 days without a chit; anything greater requires a sick leave pass from an MO/PA/NP.  If a member has been told they need a chit, it's generally because their unit doesn't allow anyone to call in, they've gone beyond their 2 days or that person has been noted to be abusing that trust and calling in when, dare I say, things are convenient.   

MM


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## Gunner98 (14 Sep 2017)

CANFORGEN 128/03 ADMHRMIL 061 241824Z OCT 03 continues to be the direction on this matter and is still the reference in the Medical Officer Course Training Standard.

As for CF2018 - medical sick chit.  Some Bases have the following in Base Routine Orders:  "The medical sick chit, CF2018, is being used by XX H Svcs C to provide a record to the member and their unit of any changes to their employment status; i.e. excused duties / sick leave or Medical 	Employment Limitations (MELs), etc.  The limitations stated are valid for up to 30 days.  Contrary to 	some bases, the member will NOT be given a copy with every visit if there is no impact upon their employment status as this generates a large amount of useless paperwork... Lastly, the member may request that they be issued a CF2018 with their visit."

Scope of practice and delegated medical acts can vary by Base, deployed setting and even doctor to doctor.  A Med Tech works under the guidance and direction of the on-duty Medical Officer (or in the case of a deployed/at sea ship, it may be a Physician Assistant).  So the Med Tech signs off on behalf of the physician in accordance with his scope and delegation.


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## Lumber (14 Sep 2017)

bruce7711 said:
			
		

> Team
> 
> I have heard, but never seen the written proof, that the CO of a unit can override a med chit issued from a CDU or Garrison Health Clinic.  Now, I am sure there are parameters and strict guidelines if such a thing exists, therefore it is probably never considered by a CO.  However, if a chit was issued for excused duties by a med tech of Cpl or lower, can the CO override that, forcing a base surgeon to re-examine the issue?



I too, am curious about this. It seems to make sense that, in a dire wartime situation, a CO could order wounded troops to grab rifles and man the line. While obviously this would only be in _extreme_ dire circumstances, the mechanism must be there somewhere, shouldn't it? However, I can't see any time when this would be justified in a non-operational setting.


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## Gunner98 (14 Sep 2017)

It is a simple matter of what the QR&O and Medical Policy state:

4.20 - GENERAL RESPONSIBILITIES OF A COMMANDING OFFICER

(1) A commanding officer is responsible for the whole of the organization and safety of the commanding officer's base, unit or element, *but the detailed distribution of work between the commanding officer and subordinates is left substantially to the commanding officer's discretion*.


34.011 - RESPONSIBILITIES OF MEDICAL OFFICERS

The senior medical officer at all levels of command *is the responsible adviser *to the senior officer exercising the function of command or executive authority on all matters pertaining to the health and physical efficiency of all personnel under his jurisdiction.



Canadian Armed Forces Medical Standards (CFP 154) A-MD-154-000/FP-000 
Chapter 4 - Medical Employment Limitations and Medical Categories

The Canadian Forces Health Services has the mandate and the *responsibility to describe and communicate to the chain of command as well as to administrative and employment authorities, a clear, concise medical opinion regarding any health-related employment limitations and their effects on the CAF member’s ability to perform expected tasks and duties safely and effectively without jeopardizing the health and safety of others, or compromising unit operational effectiveness. This information is expressed in the form of Medical Employment Limitations (MELs)*.

The process described in this chapter is essentially the practice of occupational medicine.* It requires professional medical judgment and common sense as well as a sound knowledge of the member’s work conditions, an appreciation of Canadian societal expectations and norms and some awareness of the legal considerations involved.
*


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