A NARSUM, short for Narrative Summary, is the medical report a military physician writes about you during a medical evaluation board. It lists every condition being referred to the board, describes how each one developed and has been treated, and explains how those conditions affect your ability to do your specific military job. In the military medical board process, the NARSUM is the single most important document in your file, because the Medical Evaluation Board (MEB) and the Physical Evaluation Board (PEB) can only decide your case based on conditions the NARSUM identifies.
What a NARSUM Contains
The format varies slightly by branch, but a NARSUM built to standard covers the same core ground.1SECNAV – Navy.mil. BUMEDNOTE 6320 AHLTA NARSUM for IDES
- Your identification and military history, including rank, branch, and military occupational specialty.
- Each referred diagnosis, with dates of onset or injury.
- The history of present illness, meaning how the condition began, what caused it, and how it has progressed.
- A treatment summary covering surgeries, medications, physical therapy, injections, counseling, and how you responded to each.
- Physical examination findings, including range-of-motion measurements where relevant.
- Diagnostic testing such as imaging and lab work.
- A duty-impact statement describing how the condition affects your ability to perform your job.
Under the Integrated Disability Evaluation System, the VA also conducts Compensation and Pension examinations, and those results must be considered and incorporated into the final NARSUM before the case goes to the PEB.2Tricare. Disability Evaluation System Guidebook
Why the Duty-Impact Section Decides Cases
A diagnosis by itself does not make you unfit. The physician has to translate the condition into a concrete picture of what you can and cannot do in uniform, and must state whether the condition, alone or combined with others, prevents you from reasonably performing the duties of your office, grade, rank, or rating.2Tricare. Disability Evaluation System Guidebook A bad knee might not matter for someone at a desk but could end an infantryman’s career. If the NARSUM does not make that link explicit, the PEB has nothing to work with.
Your commander adds a parallel piece. In the Air Force, commanders complete AF Form 1185, which must clearly describe how the unfitting condition affects your ability to perform assigned duties.3USAF e-Publishing. DAFMAN 48-108 Physical Evaluation Board Liaison Officer Functions The MEB reads that statement alongside the NARSUM, and a commander’s assessment that contradicts the physician’s can move the outcome. Before your commander writes it, make sure they understand the full scope of your limitations.
How the MEB and PEB Use the NARSUM
Two boards rely on the NARSUM, and each answers a different question.
The Medical Evaluation Board
The MEB is a panel of military physicians. They read the NARSUM to decide whether your conditions meet DOD medical retention standards, which are outlined in DOD Instruction 6130.03 and list conditions generally incompatible with continued service when they persist despite treatment and impair your ability to do your job.4U.S. Navy Medical Command. DoDI 6130.03 V2 Medical Standards for Military Service Retention If any condition fails those standards, your case is referred to the PEB. If all of them meet standards, you return to duty.
The Physical Evaluation Board
The PEB reviews the NARSUM, the C&P results in IDES cases, your service treatment records, and the commander’s statement to decide whether you are fit or unfit. Here is the part every service member needs to understand: the PEB can only consider conditions listed in the NARSUM or an official addendum to it. A condition that does not appear in the NARSUM cannot be evaluated, no matter how much it affects you.5U.S. Army. Physical Evaluation Boards Explained That single rule is the reason NARSUM review is not optional.
When the PEB finds you unfit, it assigns a disability rating using the VA Schedule for Rating Disabilities. It rates only the conditions that make you unfit, not every condition in your record. A rating of 30 percent or higher generally leads to disability retirement; below 30 percent, you are separated with disability severance pay.6DFAS. Qualifying for a Disability Retirement
Reviewing and Challenging Your NARSUM
Federal law guarantees that no service member can be retired or separated for disability without a full and fair hearing if they demand one.7Office of the Law Revision Counsel. 10 USC 1214 Right to Full and Fair Hearing Exercising that right starts with the NARSUM.
Once the MEB finishes, your Physical Evaluation Board Liaison Officer (PEBLO) meets with you, hands you a copy of the NARSUM and the MEB findings, explains what the board concluded, and advises you of your right to legal counsel.3USAF e-Publishing. DAFMAN 48-108 Physical Evaluation Board Liaison Officer Functions You then have five calendar days to say whether you agree or disagree.8U.S. Navy Medical Command. Disability Evaluation System Playbook for Navy and Marine Corps Service Members Silence during that window is treated as agreement, and the case moves forward.
Read the NARSUM against your own memory of your care. Is every condition listed? Is the severity of each one described accurately? Does the duty-impact section actually connect your limitations to the tasks your job requires? Missing conditions and vague impact statements are the most common problems, and both are fixable at this stage.
Independent Medical Review
If you disagree, you can request an Independent Medical Review, a clinical review of your full MEB case file by a credentialed provider who was not involved in your care. The purpose is to confirm whether the NARSUM accurately reflects all your injuries and illnesses. You have to request the IMR within the initial five-day election period, and the reviewing provider has five days to complete it. After that, you get another five days to concur with the updated findings or submit a written rebuttal.8U.S. Navy Medical Command. Disability Evaluation System Playbook for Navy and Marine Corps Service Members
Written Rebuttal
With or without an IMR, you can submit a written rebuttal challenging specific findings. A rebuttal typically argues that the NARSUM omitted a condition, understated its severity, or failed to link a condition to your inability to perform your duties. When you file one, the MEB has to prepare a surrebuttal in response before sending the case to the PEB.8U.S. Navy Medical Command. Disability Evaluation System Playbook for Navy and Marine Corps Service Members You can also ask the MEB convening authority for a brief extension, which must be granted for good cause.
Formal PEB Hearing
Appeal rights continue at the PEB. If the informal PEB finding goes against you, you can demand a formal PEB hearing with a personal appearance. There, you and your counsel can present new evidence, address the board directly, and argue for a different result.
Get Free Legal Counsel Early
Every branch offers free attorneys trained specifically for these cases. In the Army, that means Soldiers’ MEB Counsel (SMEBC) or Soldiers’ PEB Counsel (SPEBC), available in person, by video, or by phone; if you disagree with MEB findings, contact your local SMEBC office immediately because the reply window is short.9U.S. Army Medical Command. Soldiers Medical Evaluation Board and Physical Evaluation Board Counsel The Air Force equivalent is the Office of Disability Counsel, and the Navy and Marine Corps run similar programs.
An attorney cannot order a physician to change a medical opinion. What they can do is spot errors in the NARSUM, help you draft a rebuttal, gather supporting medical evidence, and represent you at a formal PEB hearing. Service members who bring their concerns to counsel early, ideally before the NARSUM is finalized, tend to come out of the process in better shape than those who wait until after the MEB has ruled.