# Medical Employment Limitation ( MEL )



## Hussar1987

All, 

Just received a notification of change of MELs.  I am an Armoured Officer and have been downgraded to O4 from O5 due to a heart issue.  Geographic is 4.  The MEL states that I unfit for operational military environments over 3 months.  

Is this me done?  To this simpleton I have got to be in breach of univerality of service.  Is this what I have to look forward to?  Med Release?

Any advice or perspective would be greatly appreciated.  I find the aval information (online) incredibly vague.  I cannot imagine a career without any opportunity to deploy again.


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## Ostrozac

Hussar1987 said:
			
		

> have been downgraded to O4 from O5



Generally speaking, the bigger the numbers, the worse your medical condition. So you can't be downgraded to 4 from 5. 5 is worse. 

Do you mean the other way around? That you used to be O4, you're now worse, and now you're O5? Or do you mean that your condition improved from O5 to O4?


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## Hussar1987

Good catch.  Yes; I am now a 4 and was a 5.


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## ModlrMike

It's good that you went from O5 to O4, but to keep some perspective, G4O4 does not have a good prognosis WRT retention.


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## Ostrozac

Based on my experience -- a member shouldn't be assigned a permanent medical category until the medical condition stabilizes. If the condition continues to improve, the member should be given the benefit of the doubt in the temporary medical category world.

Once the condition stabilizes long term, and a permanent medical category is assigned, then you start getting into the world of retention, accommodation, etc... And as stated, 04G4 isn't a great medical category.


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## CombatDoc

Is this a PCAT or TCAT?  If it's a PCAT, the permanent MELs will be assigned by D Med Pol, and if significant these will then be forwarded to DMCA for their adjudication re: Retain without Restriction/Compulsory OT/or Release.  With a PCAT of G4O4 and a limitation of "unfit deployment for periods > 3 months" the prognosis for continued service is not good, but, DMCA will make that decision regarding your career.  I recommend that you contact your local MO and Case Manager for further advice WRT the way ahead.


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## CountDC

uh uh - not absolute on the DMCA deciding.  New policy came out 1 Jul that may place it in the CO's hand.  DMCA will decide if it is low or high risk PCAT and MEL.  If low risk then they will send an advisory to the unit and the CO will have the option of retention without restrictions, retention with restrictions or recommend for release.  If high risk then DMCA will continue the process.  I received both types from them in the last two weeks.


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## xo31@711ret

nothing is absolute; I've been retired from the regs since 06; my last posting was as a Sgt at CFCC Freddy-town & BMC Gagetown doing medicals; *G4* from what I remember, was unfit because of medical limitations  or because of the unacceptable risk to the health and/or safety ;
(*G5* required scheduled specialist medical care more frequently than every six (6) months; basically meaning unfit for extended overseas employment, ships, etc  (an area that does not have ready access to FULL  medical services). Back in the 'good ol' days' of the 80's and 90's such individuals were sometimes given a base and-or desk job. But from what I understood, a person with a G4 (or G5) is  taking up a numbered position. For example a cbt arms soldier who is undeployable. So ,does the CO want an individual who cannot deploy?Is this fair? Perhap, perhaps not, depends on your opinion. Is this still the same? Probably not; like I said I retired from the regs in 06. Mike might know as retired same trade a couple years ago as a C2.


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## CombatDoc

Since I'm not retired and do actually wear a medical cap badge, I can tell you that a G4O4 PCAT is not going to be going to a CO for decision.  G4O4 permanent will be reviewed by DMCA.   The policy authorizing CO's to make this determination is only for "low risk" MELs - a G4O4 would not fall into this category.  You can argue that, but you'd only be wrong.


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## Onthewayout

Hello!

I have recently been put on a P-CAT, most of my MILs are pretty clear but there is one that leave room for interpretation...."Clerical work only"

What does that include or exclude? 

My supervisor wants me to go on parade since i dont have that restriction on my P-CAT (even if the arthritis makes it hard for me to walk around some days), does that fall under "Clerical Work"?

Please help!

Onthewayout AKA Themouse


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## George Wallace

A "Parade" is not "Clerical Work".  You have two problems here:

1.  Your supervisor is not looking at what the intent of the Doctor's chit says; and 
2.  Your Doctor/medical staff was not clear in defining what you "could not do".


An example being Parades.  Your supervisor may be looking at a Parade as a simple act of marching out onto parade, standing and then marching off parade.  He may not look at a Doctor being concerned about the degree of movement required on a parade combined with long periods of standing.  If the medical staff are not specific in what they put on your chit, you may find supervisors who will want you to do things against the intent of the chit, through those omissions.  Clarity is very important.


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## Onthewayout

Thank you for your quick reply!

I know what your saying, i've been on chist for almost 2 years before getting my P-CAT and it clearly said on thsoe "NO DRILL-NO PARADE", when my PCAT came in from Ottawa it wasn,t as clear anymore and my boss thinks i got cured by the miracle of ordinary bureaucraty...

I am trying to stay positive trough that whole getting out early situation...why do they feel like making it harder for me? Can't wait for my JPSU posting!

Guess I'm off to sick parade on Monday!!


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## medicineman

Clerical Work Only means just that...I actually prefer the term "Sedentary Duties Only", which means essentially "Sitting on your backside".  You need to have a chit clarification.

MM


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## Shamrock

medicineman said:
			
		

> Clerical Work Only means just that...I actually prefer the term "Sedentary Duties Only", which means essentially "Sitting on your backside".  You need to have a chit clarification.
> 
> MM



Which is a good point as clerks perform drill. I see quite often 'unfit military work environment' - leaves me wondering how long until someone asks for the time off.


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## medicineman

Shamrock said:
			
		

> Which is a good point as clerks perform drill. I see quite often 'unfit military work environment' - leaves me wondering how long until someone asks for the time off.



Usually those folks get employed somewhere like the rink or gym or something like that where they don't wear a uniform and don't have uniformed folks in charge of them, except for the JPSU.  Unfit military or operational environment doesn't mean unfit getting paid to go to work.

MM


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## Onthewayout

medicineman said:
			
		

> Usually those folks get employed somewhere like the rink or gym or something like that where they don't wear a uniform and don't have uniformed folks in charge of them, except for the JPSU.  Unfit military or operational environment doesn't mean unfit getting paid to go to work.
> 
> MM



This is what I've been trying to go for for almost a year now...unfortunatly it's up to the unit's discretion and my unit is very rpetty disrcet about it since everytime i ask about it no one in my immediate COC have an answer for me...This is all getting very frustrating... I didn't ask to get hurt, i got a wife and kids and the prospect of loosing my job is stressful enough without having to put up with that "lets givehim a hard time since he's almost done" kind of attitude....


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## Teager

Onthewayout i'm posted to a JPSU and I defiently understand your fears of losing your job and the stress it creates. I'm not sure about how to go about getting yourself posted to a JPSU but i'd think if you have a P-Cat talk to your career manager and get them to push for a posting there. If your feeling the stress feel free to send me a message.


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## Onthewayout

Teager said:
			
		

> Onthewayout i'm posted to a JPSU and I defiently understand your fears of losing your job and the stress it creates. I'm not sure about how to go about getting yourself posted to a JPSU but i'd think if you have a P-Cat talk to your career manager and get them to push for a posting there. If your feeling the stress feel free to send me a message.



Much appreciated!


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## Onthewayout

Called my CDU this mornign to get an official answer to give my boss, and like mentionned, clerica work pretty much means do nothing but sit at a desk (or in the canteen in my case ><) all day...thx for the help!


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## medicineman

Onthewayout said:
			
		

> This is what I've been trying to go for for almost a year now...unfortunatly it's up to the unit's discretion and my unit is very rpetty disrcet about it since everytime i ask about it no one in my immediate COC have an answer for me...This is all getting very frustrating... I didn't ask to get hurt, i got a wife and kids and the prospect of loosing my job is stressful enough without having to put up with that "lets givehim a hard time since he's almost done" kind of attitude....



OTWO - I was referring to people that have the unfit military/operational environment when I said that...alot of folks that are JPSU posted with clerical only have a uniformed job doing some sort of clerical work with another unit on base or with the JPSU themselves.  Didn't mean to confuse the issue.

MM


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## Staff Weenie

OTWO - I am a staff Officer at the DCSM/JPSU HQ in Ottawa.  I would suggest that you go to the nearest IPSC and ask to discuss the procedures for a posting to the IPSC with them.  The usual tipping point for a transfer to the IPSC is when a 6 month TCat with restrictive MELs is assigned.  Usually it's done after the assigning of the second TCat, but it can be done on the first one if the MELs are very restrictive, and the member cannot be safely employed in their unit.  

As you are on a PCat with MELs of 'clerical duty' you should really visit the nearest IPSC, and discuss the issue of a posting.  Always keep your chain of command in the loop as well. 

I know that you probably have a million questions, and more stress than anyone needs at the moment, but help is out there at the IPSC.  And, you can always contact me any time at paul.barnshaw@forces.gc.ca - I'll do whatever I can to get you an answer.


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## ArmyGuy99

OTWO,

There are several ways to get posted to JPSU/IPSC.

A little known way is to write a memo requesting it.  I did.  No problems.  Write the memo, fill out the form and send it up.  I was posted out a few weeks later.  Mind you I had the support of my CoC.  

Staff Weenie is correct though, your first stop should be to pop into your local IPSC det or at least call them.  They are a great and fantastic resource.

I'm out now, but I'm willing to help out if I can.  PM me and I'll help you anyway I can.  I'm out of town this week so I don't have access to my files, directly but It's still fresh (like 45 days ago I was a Cpl).


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## DAA

Feel free to correct me if I am wrong.  But should a posting to JPSU/IPSC only be considered in cases where a member is assigned "restrictive" MEL's and where it is not possible to advantageously or gainfully employ them within unit lines and the unit needs to free up the position to have a replacement posted in.

I know of an instance where an RMS Clk was assigned a PCAT which breaches UoS and had the restriction "Clerical duties only as tolerated".  The member was happy in their job and the unit was able to employ them, so a posting to JPSU/IPSC was not even considered nor requested by the member.  Nevertheless, it's all about the CF member and if they are NOT comfortable with the duties they are assigned and if they would "prefer" to move over to the JPSU/IPSC, then their request should be considered.

The bad thing about the wording on PCATs is that they are very "generic" in nature and subject to "creative interpretation" at unit level.  

So a unit sees the restriction of "Clerical duties only as tolerated" and then tells the member that they are required to undertake Annual Refresher Trg (ie' FA/CPR, CBRN, Ranges, etc).  Now the person has to go back to their local Health Services to get the issue resolved and may very well be viewed as a "whiner" by the CoC.


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## Teager

DAA, the JPSU/IPSC is usually a good place for members to go to who go on a PCAT and breach UoS. In your example if that person were to get posted to an IPSC they could still continue to work in the same work place working within there MEL's on a return to work. This would free up a position for the unit and also have an extra hand at no cost to the unit. The IPSC is able to support the member much better as they have the most up to date info and how too. The member will usually have many concerns and questions and most of these can be answered by a IPSC. If there are any issues at a members RTW then the member can bring them up with their IPSC CoC and it is usually fixed right away and can avoid being told to do things that go against there MEL's.


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## DAA

Teager said:
			
		

> DAA, the JPSU/IPSC is usually a good place for members to go to who go on a PCAT and breach UoS. In your example if that person were to get posted to an IPSC they could still continue to work in the same work place working within there MEL's on a return to work. This would free up a position for the unit and also have an extra hand at no cost to the unit. The IPSC is able to support the member much better as they have the most up to date info and how too. The member will usually have many concerns and questions and most of these can be answered by a IPSC. If there are any issues at a members RTW then the member can bring them up with their IPSC CoC and it is usually fixed right away and can avoid being told to do things that go against there MEL's.



Excellent point!!!  I never thought about it in this context.  I am more accustomed to seeing the, shall we say, bad side of things.

Thanks for this!!!


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## lavoie020

Good day,

I'm looking into the policy that says that after two consecutive 30 day MEL you need a TCAT. I can't seem to find it on the CMP intranet.

Can anyone point me in the right direction.

Thanks


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## Eye In The Sky

Maybe in here as a start...Part 1 is info on MELs.  

http://www.forces.gc.ca/en/about-policies-standards-medical-occupations/selected-medical-conditions.page

http://www.forces.gc.ca/en/about-policies-standards-medical-occupations/index.page


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## lavoie020

I found those, but scanning through them I didn't find anything on the two consecutive 30 day chits.

Is there an actual policy on it, or is this just what we have been doing.


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## Eye In The Sky

I am just a button monkey...here's the only other thing I can find.

http://www.forces.gc.ca/en/about-policies-standards-medical-occupations/cf-medical-category-system.page

Temporary Categories (TCats) and Permanent Categories (PCats)

11. Frequently, it becomes necessary to temporarily change one or more of the medical category factors while waiting for a medical condition to stabilize enough to allow for it to revert back to the previous Med Cat. The validity of most temporary changes shall not exceed six (6) months, but a TCat may be renewed once (i.e., maximum 12 months temporary medical category status).

12. An initial TCat may be assigned for 12 months in exceptional circumstances where there is no benefit to the member to be re-assessed at the 6 month point. Examples would include pregnancy or situations where there will be a prolonged delay in accessing definitive therapy.

13. A 12 month time frame should allow an accurate assessment of the prognosis for most medical conditions. As soon as the member's condition has plateaued and/or is not expected to significantly improve in the foreseeable future, a PCat should be assigned, even before the end of the 12-month period of TCat. A statement regarding prognosis shall be made in the PHA at the earliest reasonable time.

14. In the rare case where additional temporary status beyond 12 months may be warranted for extenuating circumstances, the case must be reviewed and approved by D Med Pol /Medical Standards section. Guidelines for the application of and approval authorities for TCats and PCats are in CF H Svcs Gp Instruction 5020-07 Changes of Medical Category or Employment Limitations.

The ref in yellow might be what you're looking for.


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## CombatDoc

Cdn_Medic said:
			
		

> Good day,
> 
> I'm looking into the policy that says that after two consecutive 30 day MEL you need a TCAT. I can't seem to find it on the CMP intranet.
> 
> Can anyone point me in the right direction.
> 
> Thanks


AFAIK, there is no hard and fast policy stating that 2 x 30 days MELs = TCAT. Each patient is assessed individually on a case-by-case basis, and the prognosis (ie outlook for recovery to full duties) drives the decision on whether a TCAT is required.


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## Mediman14

To any MO's or PA's - When a Mbr receives an MEL that states " has a chronic medical condition with high risk exacerbation if required to perform duties in hostile or life threatening environments etc (can't remember the rest), During exacerbation, requires Level 2 care. 

Does that mean "High Risk PCat"?
Is that G5 O5?


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## Armymedic

Yes.


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## ModlrMike

Without the benefit of having seen the file... that sounds about right.


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## medicineman

Rider Pride said:
			
		

> Yes.





			
				ModlrMike said:
			
		

> Without the benefit of having seen the file... that sounds about right.



Ditto


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## CombatDoc

Mediman14 said:
			
		

> To any MO's or PA's - When a Mbr receives an MEL that states " has a chronic medical condition with high risk exacerbation if required to perform duties in hostile or life threatening environments etc (can't remember the rest), During exacerbation, requires Level 2 care.
> 
> Does that mean "High Risk PCat"?
> Is that G5 O5?


I can’t say with certainty what the Geographic and Occupational factors would be that D Med Pol will likely assign, because all the details of your case are not available. For example, there may be other MELs in addition to this one. 

What I can say is that the MEL you have listed is likely to breach U of S (which would trigger 3B release). DMCA has already made changes to how they process MELs vis a vis U of S, and U of S is also being reviewed as part of The Journey project being lead by COS Strat from MPC.


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## Mediman14

I guess it would be safe to say that the Pearls of Wisdom book would change as well with the new U of S. The other MEL's include   Specialists less than every 6 months, Medical less than every 6 months, unfit shift work, no running, etc, unable to stay alert. Unfit force test, no duck, no drill,   Change positions every 5 minutes , access to lab, physio etc, flexibility in work schedule,   Clerical duties only and light physical tasks only.


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## CombatDoc

Mediman14 said:
			
		

> I guess it would be safe to say that the Pearls of Wisdom book would change as well with the new U of S. The other MEL's include   Specialists less than every 6 months, Medical less than every 6 months, unfit shift work, no running, etc, unable to stay alert. Unfit force test, no duck, no drill,   Change positions every 5 minutes , access to lab, physio etc, flexibility in work schedule,   Clerical duties only and light physical tasks only.


You have multiple MELs that likely breach U of S, although DMCA is the authority for making that determination.


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