BY ORDER OF THE SECRETARY AIR FORCE …

1 BY ORDER OF THE SECRETARY OF THE AIR FORCE AIR FORCE INSTRUCTION 10-203 20 NOVEMBER 2014 Operations DUTY LIMITING CONDITIONS COMPLIANCE WITH THIS PUBLICATION IS MANDATORY ACCESSIBILITY: Publications and forms are available on the e-Publishing website at for downloading or ordering RELEASABILITY: There are no releasability restrictions on this publication OPR: AF/SG3P Supersedes: AFI 10-203, 15 January 2013 Certified by: AF/SG (Lt Gen Thomas W. Travis) Pages: 41 This publication implements Air FORCE Policy Directive (AFPD) 10-2, Readiness. This Instruction describes how to communicate to Commanders the individual restrictions for Airmen due to medical reasons throughout the Air FORCE (AF).

2 The application of restrictions is a Commander s program that is based on medical recommendations. This Instruction applies to all Regular Air FORCE (RegAF), Air National Guard (ANG) and Air FORCE Reserve Command (AFRC) Airmen (for the purposes of this Instruction, the term Airmen refers only to military members). It interfaces with AFPD 44-1, Medical Operations, and AFPD 48-1, Aerospace Medicine Program. This publication may be supplemented at any level, but all supplements must be routed to the Office of Primary Responsibility (OPR) listed above for coordination prior to certification and approval. Refer recommended changes and questions about this publication to the OPR listed above using the AF Form 847, Recommendation for Change of Publication; route AF Forms 847 from the field through the appropriate chain of command.

3 The authorities to waiver wing/unit level requirements in this publication are identified with a Tier ( T-0, T-1, T-2, T-3 ) number following the compliance statement. See AFI 33-360, Publications and Forms Management, Table for a description of the authorities associated with the Tier numbers. Submit requests for waivers through the chain of command to the appropriate tier waiver approval authority, or alternately, to the publication OPR for non-tiered compliance items. This instruction requires the collection and maintenance of information protected by the Privacy Act of 1974 and the Health Insurance Portability and Accountability Act of 1996 (HIPAA).

4 Authority to collect and maintain records prescribed in this AFI are outlined in Title 10, United States Code, Sections 1071-1097b. The applicable Privacy Act System Notice is F044 F SG E, Electronic Medical Records System. Ensure that all records created as a result of processes prescribed in this publication are maintained in accordance with Air FORCE Manual (AFMAN) 33-363, Management of Records, and disposed of in accordance with the Air FORCE Records 2 AFI10-203 20 NOVEMBER 2014 Disposition Schedule (RDS) located in the Air FORCE Records Information Management System (AFRIMS). The use of the name or mark of any specific manufacturer, commercial product, commodity, or service in this publication does not imply endorsement by the Air FORCE .

5 SUMMARY OF CHANGES This document has been substantially revised and must be completely reviewed. The major changes include: Tiers were added for waiver authority for Wing Level or below requirements. Clarification was made on the location of initial Review-in-lieu-of Medical Board (RILO) review for the Air Reserve Component (ARC) to align with AFI 41-210, TRICARE Operations and Patient Administration Functions. Updates were made to realign Public Health and Medical Standards Management Element functions. The Exercise Physiologist and exercise prescription references were removed. There is no longer a requirement by this AFI for an exercise prescription.

6 Chapter 1 GENERAL PROVISIONS 4 Purpose.. 4 Physical Profile System to include Physical Profile Serial Chart (PULHES).. 4 Duty limitations.. 5 Special Considerations.. 6 Chapter 2 ROLES AND RESPONSIBILITIES 7 Chief of Staff of the Air FORCE .. 7 Air FORCE Surgeon General.. 7 Air FORCE Medical Operations Agency (AFMOA) Aerospace Medicine.. 7 MAJCOM SGP or ARC/SGP shall: .. 7 Installation Communications Squadron/Group shall.. 7 MTF Commander (MTF/CC) shall: .. 7 MTF SGP shall: .. 8 MTF SPO shall: .. 8 MTF SGH shall: .. 9 Clinic Providers (including specialty providers within the MTF) shall: .. 9 Competent Medical Authority (CMA).. 11 Clinical Consultants shall.

7 11 Profiling Officer (PO) shall: .. 12 MSME shall: .. 12 PH (or ARC equivalent) shall: .. 14 Women s Health Clinic (not applicable to ARC).. 15 AFI10-203 20 NOVEMBER 2014 3 Unit Commander shall: .. 15 Airman shall: .. 16 Military Personnel Flight or Section (MPF, FSS or MPS).. 16 AFPC/DPANM (ARC/SGP).. 17 Chapter 3 ESTABLISHING AND DISSEMINATING DUTY LIMITATIONS 18 General Requirements.. 18 FRs and FAEs.. 19 DRs Only.. 20 MR.. 21 Pregnancy-related Duty Limitations.. 22 Multiple Action AF Form 469.. 23 External duty limitations (civilian or sister service).. 23 Dental.. 23 Chapter 4 DAWG CASE MANAGEMENT REVIEW 24 Routine DAWG Case Reviews.

8 24 DAWG Review for Initial RILO.. 27 Metrics.. 29 Chapter 5 FITNESS FOR DUTY (FFD)/ WORLD WIDE DUTY (WWD) AND PRESUMPTION OF FITNESS 31 ARC Airmen.. 31 Presumption of Fitness.. 31 Chapter 6 LIMITED SCOPE MEDICAL TREATMENT FACILITIES (LSMTF) AND MEDICAL AID STATIONS (MAS) 32 Definitions.. 32 Responsibilities.. 32 Attachment 1 GLOSSARY OF REFERENCES AND SUPPORTING INFORMATION 35 4 AFI10-203 20 NOVEMBER 2014 Chapter 1 GENERAL PROVISIONS Purpose. This Instruction establishes procedures for the documentation and administrative management of Airmen with injuries or illnesses that may impact their ability to perform their military duty. These procedures have been developed to ensure maximum utilization and readiness of personnel, while preserving their health and minimizing risk of further injury or illness.

9 This Instruction and AFI 41-210, TRICARE Operations and Patient Administration Functions, describe appropriate courses of action for Integrated Disability Evaluation System (IDES) pre-screening disposition when individuals have medical conditions potentially affecting their continued retention for military service or deployability in the Air FORCE (AF), as outlined by the standards per AFI 48-123, Medical Examinations and Standards. This Instruction provides a method to communicate medical recommendations to Commanders. This will allow optimum utilization of Airmen in their charge within the guidelines of the medical recommendations and ensure timely return to duty following medical evaluations related to potentially unfitting conditions.

10 Commanders may consult with the medical unit s Senior Profiling Officer (SPO) to maximize use of personnel with Duty Limiting Conditions (DLCs). An assessment based on operational risk of personnel assigned to a unit is critical to maintaining unit readiness at the highest degree possible. Purpose of AF Form 422, Duty Limiting Condition Report. The AF Form 469 is used to describe physical limitations and recommend duty restrictions (DR) to the Commander when there is a potential risk to an Airman s health, safety and well-being, the safety of the mission, or the ability of the Airman to effectively accomplish the mission. Additionally, the AF Form 469 is used to convey limitations related to the AF Fitness Program (FP) as well as Fitness Assessment Exemptions (FAE).