Posted on Dec 16, 2015
Cmd Authority: What regulation allows Commanders or Command elements to assume medical treatment plans or limitations are a recommendation?
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I really need help with this one regulation buffs? AR 600-20 changed in 2007. What I found void, was Command authority regarding profiles. Leaning to AR 40-501, I found that Commanders who disagree with medical limitations must dispute the matter beginning with a provider, but may dispute as high as a Hospital Commander.
I've seen my share of Commanders and Command elements losing careers based on use of their discretion that proved to be personal versus law or regulation derived. I've seen my share of death and permanent injury due to Commanders and Command elements assuming medical opinion as advisement they have discretion to override in uniform and in my current career. Assumption is personal when it comes to Command authority and has proven itself to be costly. Law and regulation protect decision makers and those that are subject to authority. NCOs protect and advise Commanders on regulation. What regulation can you find regarding this subject and what is your opinion?
I've seen my share of Commanders and Command elements losing careers based on use of their discretion that proved to be personal versus law or regulation derived. I've seen my share of death and permanent injury due to Commanders and Command elements assuming medical opinion as advisement they have discretion to override in uniform and in my current career. Assumption is personal when it comes to Command authority and has proven itself to be costly. Law and regulation protect decision makers and those that are subject to authority. NCOs protect and advise Commanders on regulation. What regulation can you find regarding this subject and what is your opinion?
Authority
Profiles
Medical
Regulation
Law
Edited 9 y ago
Posted 9 y ago
Responses: 2
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As a peer I would offer this:
If my commander were entertaining the idea of overriding a profile (regulations be damned), that is something I would go into his office, shut the door, and get into his a$$ about. There is just no valid or defensible reason to risk aggravating or permanently injuring a Soldier because the CO thinks he's smarter than the doctor. If he went ahead anyway, I would make a memorandum for record and keep it handy in case it was needed later.
I owe it to the commander to keep him out of trouble, and I owe it to the Soldier to take care of his medical needs.
I hope this helps, 1SG Henry Yates.
If my commander were entertaining the idea of overriding a profile (regulations be damned), that is something I would go into his office, shut the door, and get into his a$$ about. There is just no valid or defensible reason to risk aggravating or permanently injuring a Soldier because the CO thinks he's smarter than the doctor. If he went ahead anyway, I would make a memorandum for record and keep it handy in case it was needed later.
I owe it to the commander to keep him out of trouble, and I owe it to the Soldier to take care of his medical needs.
I hope this helps, 1SG Henry Yates.
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1SG Henry Yates
Thanks 1SG, in my current career, I face matters such as this often and I've been able to resolve it at the lowest level. I remember AR 600-20 requiring a memorandum of understanding for Commanders who would take full responsibility for consequences, or further injury to a Soldier. The 2007 update to the regulation no longer gives that authority. The only other resource I found regarding Command authority with profiles was in AR 40-501. In this AR, Commander's disagreeing with profiles must begin a process of review starting with the PCM and may go as high as the Hospital Commander. I am attempting due diligence to make sure I get this right. I'm still an NCO at heart beyond the uniform now that I'm retired and in the GS system. I meet with Command teams often to fix problems versus lodging complaints. Thank you 1SG.
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There is a new profile that will be out shorty where the commander has to sign it for it to be valid. Currently a commander cannot unilaterally declare it invalid.
Under current regulation everything you say above is true. I also recommend a commander can talk directly to the provider and their supervisor about any profile. Sometimes you have inexperienced , but well intending providers writing these things and upon review they are willing to change what is written.
Personally, I have also sent profiles to my boss and trial counsel for review as there are limitations to what a provider can write for, specifically when they involve AR 670-1 exceptions to policy.
I highly recommend the commander just approve most profiles and the ones that seem unreasonable they should talk to their surgeon or the issuing provider as they may have more information.
Under current regulation everything you say above is true. I also recommend a commander can talk directly to the provider and their supervisor about any profile. Sometimes you have inexperienced , but well intending providers writing these things and upon review they are willing to change what is written.
Personally, I have also sent profiles to my boss and trial counsel for review as there are limitations to what a provider can write for, specifically when they involve AR 670-1 exceptions to policy.
I highly recommend the commander just approve most profiles and the ones that seem unreasonable they should talk to their surgeon or the issuing provider as they may have more information.
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1SG Henry Yates
Thank you Sir, you hit that on the head. Some of our PAs are learning the ropes and clarification is always a good thing. I will follow your example in advising Command teams in future issues that are reported to us. Surgeons are also willing to clarify their intent on limitations and adjust unreasonable limitations as well. I had an NCO who begged to go to a major training deployment and her profile was too limiting. The Commander and I worked with the PCM and created a role for her in our Company Ops that met all accommodations needed to allow her to deploy and we made arrangement to accommodate movement of her gear as well. She's a troop who really taught me something I'll never forget. Soldiers with physical limitations still have the mission at heart especially when my Commander and I kept them in the team. That NCOs actions added more #s of profiled Soldiers requesting to attend training and our unit morale was through the roof. Our only red tape was creating viable accommodations. That same unit broke records at JRTC to return the unit status from non-deploy-able back to a deploy-able status under training. Thank you for the update on profiles. I'll be looking for it and I really appreciate you sharing your leadership. You and 1SG have really helped me in my current GS role and given me perspective on profiling authority. Thank you Sir.
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