AR 40-501 pg 30
3–27. Miscellaneous respiratory disorders
The causes for referral to an MEB are as follows:
a. Asthma. This includes reactive airway disease, exercise-induced bronchospasm, asthmatic bronchospasm, or
asthmatic bronchitis within the criteria outlined in paragraphs (1) through (4) below.
(1) Definitions/diagnostic criteria are as follows.
(a) Asthma is a clinical syndrome characterized by cough, wheeze, or dyspnea and physiologic evidence of
reversible airflow obstruction or airway hyperactivity that persists over a prolonged period of time (generally more than
6 to 12 months).
(b) Reversible airflow obstruction is defined as more than 15 percent increase in forced expiratory volume in 1
second (FEVI) following the administration of an inhaled bronchodilator or prolonged corticosteroid therapy.
(c) Increased bronchial responsiveness is the presence of an exaggerated decrease in airflow induced by a standard
bronchoprovocation challenge such as methacholine inhalation (PD20 FEV1 less than or equal to 4mg/ml). Demonstration
of exercise induced bronchospasm (15 percent decline in FEV1) is also diagnostic of increased bronchial
responsiveness; however, failure to induce bronchospasm with exercise does not rule out the diagnosis of asthma.
Bronchoprovacation or exercise testing should be performed by a credentialed provider privileged to perform the
(d) If at the end of that period, the Soldier is unable to perform all military training and duty as cited below, the
Soldier will be referred to MEB.
(e) Acute, self limited, reversible airflow obstruction and airway hyperactivity can be caused by upper respiratory
infections and inhalation of irritant gases or pollutants. This should not be permanently diagnosed as asthma unless
significant symptoms or airflow abnormalities persist for more than 12 months.
(2) Chronic asthma is cause for a permanent P-3 or P-4 profile and MEB referral if it—
(a) Results in repetitive hospitalizations, repetitive emergency room visits or excessive time lost from duty.
(b) Requires repetitive use of oral corticosteroids to enable the Soldier to perform all military training and duties.
(c) Results in inability to run outdoors at a pace that meets the standards for the timed 2-mile run despite
medications. (The P–3 for the inability to perform the run refers to the inability due to asthma and should not be
confused with giving an L2 or L3 based on an underlying orthopedic condition that requires an alternate Army Physical
Fitness Test (APFT).)
(d) Prevents the Soldier from wearing a protective mask.
(3) All Soldiers meeting an MEB for asthma should receive a consultation from an internist, pulmonologist, or
(4) Chronic asthma meets retention standards, but is a cause for a permanent P–2 profile if it—
(a) Requires regular medications including low dose inhaled corticosteroids and/or oral or inhaled bronchodilators;
(b) Does not prevent the Soldier from otherwise performing all military training and duties including the 2 mile run
within time standards.
(5) Soldiers with a diagnosis of asthma who require no medications or activity limitations require no profiling