DA Form 3947. Medical Evaluation Board Proceedings

The DA Form 3947 is used by the U.S. military to document the medical evaluation of service members who may have medical conditions that impact their fitness for duty or disability compensation. This form is a critical component of the evaluation process and is used to record medical diagnoses, recommendations, and actions taken by the Medical Evaluation Board (MEB).

Form Structure: The DA Form 3947 consists of six pages with several sections:

Page 1:

• Section for attaching relevant files (indicated as Attach File(s)).
• Service member's personal information:
  • Name (Last, First, MI)
  • Pay Grade
  • Date of Birth
  • Gender
  • SSN (Social Security Number)
  • Component (e.g., Regular, National Guard, Reserve)
  • Organization/Unit
  • Primary Military Occupational Specialty (MOS) or Area of Concentration (AOC) with code
• Medical Evaluation Board Proceedings:
  • Diagnosis
  • Approximate Date of Origin
  • Meets/Does Not Meet AR 40-501 Retention Standards
  • Existed Prior to Service (Yes/No)
  • Permanently Aggravated by Service (Yes/No)
  • Section for service-specific information.

Page 2:

• Action by the Board section:
  • Diagnosis and evaluation results for specific medical conditions.
• Service Member Review Action:
  • Declaration of agreement or disagreement with the Board's decision.
• Impartial Medical Review (IMR) Action:
  • Service member's choice to request or not request an IMR and declaration of agreement or disagreement with the MEB.

Page 3:

• Final Service Member Review Action:
  • Confirmation of the Service Member's decision regarding the MEB.
• Final Action by Approval Authority:
  • Approval authority's decision regarding the MEB with options to amend the MEB decision.
• Review of the Approval Authority's Final Decision by the Service Member.

Page 4:

• Instructions for completing the form, including definitions and guidance for each block.
• Medical Treatment Facility/MEB Site: Identification of the MEB location, date, and service member's information.
• Blocks for service member's personal information and diagnosis details.

Page 5:

• Continued instructions for completing the form.
• Service Member Action:
  • Completion of sections related to the service member's agreement or disagreement with the MEB decision and their request for an IMR.
• Impartial Medical Review Actions:
  • Completion of sections related to the service member's request or non-request for an IMR.

Page 6:

• Final sections for service member review, approval authority's action, and service member's confirmation of the approval authority's decision.

Additional Information:

• The DA Form 3947 is a vital document in the process of evaluating a service member's fitness for duty and potential disability compensation.
• It is used to record medical diagnoses, review actions, and recommendations by the Medical Evaluation Board.
• The form plays a crucial role in ensuring that service members receive appropriate medical evaluations and make informed decisions about their military careers and potential transitions.
• The form is utilized for individuals across different components of the U.S. military, and its completion requires careful consideration and documentation of medical conditions and their impact on a service member's fitness for duty.