SUPPORTING STATEMENT
A. JUSTIFICATION
1. Need for Information Collection
Title 10 USC, Sections 504, 505, 507, 532, 978, 1201, 1202, and 4346; and E.O. 9397, require military applicants to meet medical accession standards for enlistment, induction and appointment to the Armed Forces (Atch 1). The DD Form 2807-1, “Report of Medical History" and the DD Form 2807-2, "Medical Prescreen of Medical History Report" are designed to appropriately collect this information (Atch 2). Data are needed from military applicants to elicit a more accurate picture of their well being and medical history.
This information collection is the basis for determining medical eligibility of applicants for entry in the Armed Forces. This information is needed to determine the medical qualifications of applicants based upon their current and past medical history.
2. Use of Information
Applicants for initial entry into the Armed Forces and Service members requiring mandatory medical examinations, medical boards and other physical examination shall complete the DD Form 2807-1. All initial entry applicants required to complete a chapter #2 physical examination will complete the DD Form 2807-2 prior to the medical examination. The purpose of this information is to gather the necessary initial data for determining the applicants’ medical eligibility and qualification for the Armed Forces and to establish the initial medical record.
The information obtained on the DD Form 2807-2 (applicant’s medical prescreen) ensures the recruiter that an applicant has identified any medical disqualifying condition(s) prior to the application process and meets the Congressional requirements to obtain both the applicants Health Care provider and Insurance provider. Additionally, it allows the military examining physician to obtain medical records critical to evaluating the applicant’s medical condition(s) prior to their medical examination. The DD Form 2807-1 (medical history form), which goes into more detail than the DD Form 2807-2, is needed as part of the required medical examination to assist physicians in making determinations as to acceptability of applicants for military service and verifies disqualifying medical condition(s) noted on the prescreening form. Approximately 100,000 applicants will not meet the medical entry standards and will not require medical examination after completing the DD Form 2807-2 due to pre-existing medical conditions.
The DD Form 2807-1 may also be use by all Service members for retention and medical boards and other essential medical examinations as required by the Services.
The Military Services and the Coast Guard will use these data to evaluate applicants’ medical status in determining eligibility for enlistment, appointment or induction and to evaluate the entry standards for the Armed Forces. Data are also used to decrease premature medical discharges categorized as “Existing Prior to Service.” The DD Form 2807-2, “Medical Prescreen of Medical History Report,” will be completed by the recruiter, the applicant, and possibly a family member. It will be used to determine any disqualifying medical condition prior to physical examination and will be used to assist the physician in collecting medical information essential for completing the medical examination and determining the applicants' qualification or disqualification. The DD Form 2807-1, “Report of Medical History,” is completed at the military entrance processing station by applicants and medical personnel. This information is collected and reviewed by physicians performing the entrance medical examination to determine the applicants’ eligibility. The information collected becomes a part of the applicants’ medical records.
3. Improved Information Technology
The Department has determined that the DD Form 2807-1 and DD Form 2807- 2 are appropriate for electronic generation. Recruiting stations able to produce the form electronically will reduce the burden for not only the respondent, but for the recruiter as well. Forms are available on the DoD Electronic Forms Website in Fillable Adobe PDF and used by the Military Entrance Processing Command (MEPCOM) Integrated Resource System (MIRS) at Military Entrance Processing Stations (MEPS), the Department of Defense Medical Examination Review Board (DODMERB), and by medical practitioners performing physical examinations.
The Military Entrance Processing Command (MEPCOM) is responsible for loading the DD Form 2807-1 and DD Form 2807‑2 into the MEPCOM Integrated Resource System (MIRS) to enable respondents to electronically complete the form.
Strategic planning has led to research and development for ongoing initiatives, including biometrics, towards the creation of an e-Medical record. Conceptually, these forms will be the genesis of the individual's e-Medical record. Progress of this initiative is contingent upon funding availability.
4. Efforts to Identify Duplication
The medical prescreen will identify medical conditions which are permanently disqualifying for applicants, stopping the recruiting process and decreasing medical cost and recruiters time. The duplication of data between the medical prescreen and the medical history form will allow MEPCOM to validate the data obtained from an applicant thus decreasing the incidence of conditions listed as existing prior to Service. It will allow the applicants to obtain medical records, prior to their medical examination, based upon their answers and their consent to release the medical records to the examining facility. This data will assist the practitioner in determining their qualification or disqualification for the Armed Services.
Data collected on the DD Form 2807-1 and DD Form 2807-2, provide a wide range of medical data needed to establish eligibility for enlistment, commissioning or appointment in the Armed Forces. No culmination of data from other sources would provide the necessary information for entrance.
5. Methods Used to Minimize Burden on Small Entities
Small businesses and other small entities will not be affected by this collection.
6. Consequences of not Collecting the Information
Information is collected only once per applicant. If collection were stopped, ability to make determinations for enlistment, appointment or commissioning into the military would be hampered and the present and past medical status of the applicant could not be ascertained. Additionally, force readiness and health postures would be affected.
7. Specials Circumstances
There are no special circumstances in this data collection.
8. Agency 60-Day Federal Register Notice and Consultations Outside the Agency
The 60-day Federal Register Notice announcing this information collection (as required by 5 CFR 1320.8(d)) was published on July 31, 2006, Volume 71, Number 146, pages 43135-43136 (Atch 3). No comments were received in response to this collection.
This information has been reviewed by the Military Services. A Joint Service working group reviewed all enlistment forms to determine which forms would be candidates for electronic generation and make any recommend changes. The working group did not recommend any changes to the DD Form 2807-1 and DD Form 2807-2 at this time.
9. Payments to Respondents
No payments, gifts or guarantees are made to respondents who provide this information.
10. Assurance of Confidentiality
Respondents are advised that statements will be held in strictest confidence. Forms maintained in medical records are seen only by individuals who have a need to verify information contained on the form. The privacy act statement is contained on the medical jacket and both forms.
11. Sensitive Questions
The DD Form 2807-1 and DD Form 2807-2 include questions which may be considered sensitive in nature. These forms are the genesis for the personnel record, the medical record, and the security records. The Social Security Number (SSN) is obtained and stored into the initial record (personnel, finance, medical, and security) for proofing, vetting, and maintaining unambiguous person identity for U.S. persons. With the SSN being used for person identification in major DoD human resource systems (personnel, finance, and medical); it remains the only unique identifier that ensures accuracy across all the systems to ensure proper data retrieval. The Social Security Number is used to correctly identify the applicant through the accession process and to ensure the proper information is obtained from medical authorities. Questioning applicants solicits information which may not readily be divulged by applicants. Certain questions help reveal if there are congenital anomalies which are disqualifying for entrance into the military. Questions concerning family history may reveal a history of active disease(s) which would require additional reporting and precautionary procedures (i.e., drug and alcohol abuse, psychiatric treatment, or other medical conditions would require additional evaluation). Any positive history of specific medical conditions may disqualify the applicant for entrance into military service.
12. Estimates of Annual Response Burden and Labor Cost for Hour Burden to the Respondents for Collection of Information
a. Response Burden:
(1) DD Form 2807-1
Total annual respondents: 350,000
Frequency of response: 1
Total annual response: 350,000
Burden per response: 10 minutes
Total burden hours 58,333 hours
(2) DD Form 2807-2
Total annual respondents: 450,000
Frequency of response: 1
Total annual response: 450,000
Burden per response: 10 minutes
Total burden hours 75,000 hours
(3) Medical Providers (required civilian medical records)
Total annual respondents: 50,000
Frequency of response: 1
Total annual response: 50,000
Burden per response: 3 minutes
Total burden hours 2,500 hours
(4) . Total Average Estimated Response Burden.
Total annual respondents: 800,000
Frequency of response: 1
Burden per response: 10 minutes
Total burden hours: 133,333 hours
Total annual respondents: 50,000
Frequency of response: 1
Burden per response: 3 minutes
Total burden hours 2,500 hours
TOTAL RESPONDENTS 850,000
TOTAL BURDEN 135,833 hours
ANNUAL AVERAGE MINS: 135,833/850,000 = .1598 hrs x 60 mins =
9.6 mins
b. Explanation of How Burden was Estimated:
An observed overall average of 10 minutes was taken to complete the DD Form 2807-1 and DD Form 2807-2.
c. Estimated Cost to Respondents.
(1) DD Form 2807-1 and 2807-2
800,000 respondents x $5.15/hr* @ 10 mins. Per Form = $686,666.
*Hourly rate based on U.S. Department of Labor federal minimum wage.
(2) Medical Providers (civilian medical records)
The requirement estimated for a medical provider to review and provide
information annotated on the form has been estimated at:
50,000 respondents x $30.06/hr** @ 3 mins Per Form = $75,150.
** Hourly rate based on average Chief Medical Officer (GS12/step 5) salary
13. Estimates of Cost Burden for Respondents for Collection of Information
a. Total Capitol and Start-up Costs. There are no capitol or start-up costs associated with this collection.
b. Operational and Maintenance Costs. There are no operational or maintenance costs associated with this information collection. The medical records from the medical providers during the initial entry process are paid for in accordance with their civilian fee for records, as a result we are not including operational cost for this process.
14. Estimates of Cost to the Federal Government
a. Work Load Requirements
1. E5-E7 recruiters process forms. Estimated completion time is 10 minutes per form.
2. GS-05/Step 05 medical personnel review items to determine completeness of the responses. Estimated completion time is 5 minutes per form.
b. Estimated Costs: (DD Form 2807-1 and DD Form 2807-2)
1. E5 - E7 hourly pay = $15.08 @ 20 minutes for both forms $ 5.03
2. GS-05/Step 05 hourly pay $13.68 @ 10 minutes for both forms $ 2.28
Cost to the Federal Government per respondent $ 7.31
Total Cost for forms (800,000 X $7.31) $5,848,000
c. Cost for medical Records (50,000 X $5.03 average) $251,500
Total DoD Cost $6,099,500
15. Changes in Burden
There is no projected increase in burden hours.
16. Publication Plans/Time Schedule
Results of this information collection will not be published.
17. Approval not to Display Expiration Data
Approval not to display the expiration date is not being sought.
18. Exceptions to the Certification Statement
No exceptions to the certification statement are being sought.
B. COLLECTION OF INFORMATION EMPLOYING STATISTICAL METHODS
Statistical methods are not employed for this collection of information.
| File Type | application/msword |
| Author | OUSD-PR |
| Last Modified By | pltoppings |
| File Modified | 2007-01-24 |
| File Created | 2006-12-28 |