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Medical Chits

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,

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  My question is....my current chain of command is hounding me about my chit being outdated and no longer current or valid.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.
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.
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.
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....
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.   
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.
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.
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.

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

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. 

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.
bruce7711 said:

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


(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.


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.