Questions about medical board discharge process

[hrglynn]

Hi all, 

I'm new to the forum (after many months of lurking ) and I hope this is the right place for this question; if not, I apologize!

I'm trying to find information about the medical discharge process (just in general, not for any particular soldier--I'm writing a fiction novel and want to be as accurate as possible).  I know that cases were reviewed by medical boards to determine fitness for further service, but did the soldier have to travel somewhere TO the medical board?  Did they ask him questions about his condition, or would they have been in communication with his doctor/nurses already regarding specific diagnoses?  If a soldier was not expected to recover, could he be discharged very quickly after wounding and then spend more time in hospital?  Basically I'm curious about the logistics of the process.  

Thank you in advance for any information you are able to provide!
Hannah

[TEW]

Can't say I know that much about the medical boards but there were Standing Medical Boards and Travelling Medical Boards. I've just checked an officer's file and he said he couldn't make it to a medical board due to his injuries!

Men attended MBs after they had been discharged, this was for assessment of condition for pension purposes. Discharged men could be sent for a course of treatment.

I'm not so sure about men being reviewed by MB to determine fitness for further service. There was a MB proir to discharge, the ones I have were undertaken at the hospital, the man being discharged from the Army & Hospital the same day with a pension to be reviewed in three months by another MB.

At an extreme level some men were discharged from the Army directly to an Asylum.

TEW

[MaureenE]

The following are available online on Archive.org.

"Appendix: Medical Reports on Discharged Soldiers" page 114 The Soldier's Heart and the Effort Syndrome by Thomas Lewis MD FRCP [1918] Archive.org.  The Preface states ” It is written primarily with the intention of helping medical officers of recruiting, discharging and pensioning boards and …”.

A vision of the possible; what the R.A.M.C. might become; an account of some of the medical work in Egypt together with a constructive criticism of the R.A.M.C by James W Barrett, Temporary Lieut-Col RAMC 1919 Archive.org

The author was President of a Medical Standing Board in Egypt  (Egyptian Expeditionary Force, E E F) during the war years.

Maureen

 

[ss002d6252]

8 hours ago, hrglynn said:

Hi all, 

I'm new to the forum (after many months of lurking ) and I hope this is the right place for this question; if not, I apologize!

I'm trying to find information about the medical discharge process (just in general, not for any particular soldier--I'm writing a fiction novel and want to be as accurate as possible).  I know that cases were reviewed by medical boards to determine fitness for further service, but did the soldier have to travel somewhere TO the medical board?  Did they ask him questions about his condition, or would they have been in communication with his doctor/nurses already regarding specific diagnoses?  If a soldier was not expected to recover, could he be discharged very quickly after wounding and then spend more time in hospital?  Basically I'm curious about the logistics of the process.  

Thank you in advance for any information you are able to provide!
Hannah

Are you looking at s soldier who was already in a hospital or a soldier just being discharged through demobilization?

Craig

[hrglynn]

Sorry, I should have clarified! I'm looking for information about soldiers who were already in hospital, not just being discharged through demobilization.

[kenf48]

 

12 hours ago, hrglynn said:

I know that cases were reviewed by medical boards to determine fitness for further service, but did the soldier have to travel somewhere TO the medical board?  Did they ask him questions about his condition, or would they have been in communication with his doctor/nurses already regarding specific diagnoses?  If a soldier was not expected to recover, could he be discharged very quickly after wounding and then spend more time in hospital? 

1 hour ago, hrglynn said:

Sorry, I should have clarified! I'm looking for information about soldiers who were already in hospital, not just being discharged through demobilization.

It was a fairly complex system which was adapted throughout the war.  Is your subject an officer or  other rank?

The Standing Medical Boards referred to above were abolished in July 1916. 

The Travelling Medical boards examined men who were classed as unfit by the officer in command of a unit.  They would also attend the Command Depots to assess fitness

As noted above Pension Boards were held in conjunction with Recruitment Boards.

See Medical History of the War https://ia902707.us.archive.org/10/items/medicalservicesg01macpuoft/medicalservicesg01macpuoft.pdf

 

 

By December 1917 permanent discharge centres had been set up in each Command District within the UK.  

Men in hospital were discharged by the hospital invaliding board. (Army Form W.3972B (attached)

Men were retained on the the Reserve strength whilst in hospital (there was a thread recently which showed a group of limbless men in 'hospital blues' awaiting a new limb before being discharged).

If you have access to service records this man's record is illustrative for this period.  He was wounded around the 20th March, and a telegram sent showing he was 'dangerously ill'.  He was fit enough to be moved on the 7th April when he was returned to the UK.  There is a great deal of correspondence requesting his medical board, and a hand written note saying he would require a "bedside board".  He was eventually discharged as shown on the attached form in January 1919 with 100% disability.

 

 

 

[hrglynn]

Ah, I see, that's very helpful!  And thank you Maureen - the Medical Reports on Discharged Soldiers looks promising as well.

Let's say I'm a private who receives a chest wound in Belgium in Dec. 1917.  (I know soldiers could recover from chest wounds and return to their unit, but for the sake of argument here let's say I develop lung issues, etc and I WILL ultimately receive a medical discharge for this.)  If I'm evacuated to England in Jan. 1918 and then am in hospital with repeated complications, would I have to wait for the complications (infection, haemothorax, etc) to clear up before going before a hospital invaliding board?  Alternatively, what would warrant a "bedside board" instead, as in the case above?

[TEW]

Not sure if you're still looking for information  but I found an example file on Ancestry & FMP, hope you have access!

The man received a GSW chest in Sept 1917, evacuated to UK October 1917 and hospitalised. Complications arose with a haemothorax!, collapsed lung and a foreign body in the liver.

Discharged 2/6/1918 under KR 392 xvi (wound).

There are Medical Reports and Medical Boards in his file. Some sheets are muddled up and out of order. Apart from the date not matching your scenario it all fits quite well.

To find the record.

He is John Charles Gilbert, Machine Gun Corps 2181. An Ancestry 'All Military' search on surname and number will find him.

The complicated bit is that I found him via a Sick/Wounded List with his later number of 9288 which I think Find my Past have indexed him under.

If you find him on Ancestry the 'first' page is filmstrip 3906/42923. His actual first page is 3889/42923.

TEW

 

[hrglynn]

This is very useful, thank you! I had resigned myself to just clicking through the general Service Records on Ancestry hoping to find something like this, with minimal success.  

It looks like this man was initially reclassified B iii in April 1918 (which I think means fit only for sedentary work?) and eligible for transfer to class P of the reserve, then discharge papers signed mid-May (effective 2 June).  I see on The Long, Long Trail that "Men in Classes P and P(T) were, for the purposes of pay, allowances, gratuity and pension, treated as if they been discharged on the date of their transfer to Class P or P(T)."  Would this man's June discharge remove him from the Reserve as well?  

I also see that between his reclassification on 18 April and the Ministry of Pensions decision on 22 May, he was on furlough (26/4/18-6/5/18), so I'm curious what might have happened in the interim that would warrant a full discharge.  Obviously he had been severely wounded, but it seems that the May medical board must have decided he was in worse condition than in April.  

Not to be too greedy with questions, but I also see that the Ministry of Pensions said he should be sent to a seaside convalescent home for 6 months, presumably because sea air was thought to be beneficial to lungs.  Was there any way of monitoring whether the soldier went or not, given that he'd already been discharged?

[Matlock1418]

 

5 hours ago, hrglynn said:

Not to be too greedy with questions, but I also see that the Ministry of Pensions said he should be sent to a seaside convalescent home for 6 months, presumably because sea air was thought to be beneficial to lungs.  Was there any way of monitoring whether the soldier went or not, given that he'd already been discharged?

Once discharged - The Ministry of Pensions could make getting a pension dependant on getting treatment/continued treatment [TB treatment and physiotherapy being a couple of examples I can think of] - and the MoP could withhold a pension if they thought it was necessary to encourage a man to go to get treated.  Obviously it had to be something that could be treated - missing limbs could not be biologically renewed though prosthetics could be made available to decrease a man's practical level of disability and thus to increase his employability.  Training could be provided both for use of prosthetics and in new occupational skills.

After all the pupose of many a pension was essentially to help to get a temporarily and/or partially disabled man back towards self-sufficiency and off state funding as soon as possible, if possible.

"Treatment" is a notation clearly seen on some pension index cards at WFA/Fold3.  One suspects that at the time in the main Awards files it also appeared frequently [Unfortunately most such files were deliberately destroyed once their use was passed.  A few sample files were retained as "PIN 26" at TNA and may perhaps shed some more light the treatment of disabilities - unfortunately these "PIN 26" files are not digitised so need to be physically accessed and are of variable content].  Various treatment centres were set up by the MoP for day and residential attendees.  One presumes they kept attendance records [I don't know if any such records might survive]

One disease that was treated very carefully was TB - considered to be 100% disability and a candidate for treatment [after all, who wants a TB suffererer going or trying to go to work?]  Wholesome fresh air was a key part of that treatment.

Although changing over time there were clear scales of defined pension according to rank class and degree/% level of disablement.

Of course if a man's disability was considered reduced over time the pension would be correspondingly reduced and in many pension cases were brought to a final close with a lump-sum gratuity payment [typically when considered less than 20% disability].

The MoP would track and motivate as they felt necessary to get those men they felt could be got off pensions off them as soon as possible.  Or sometimes potentially and/or actually cease providing a pension altogether because of non-compliance with their treatment attendance requirements. Tough love it seems [Plus ça change!]

M

Edited 2 February , 2022 by Matlock1418
addit

[TEW]

My understanding of the subtleties if the discharge process is not really up to it. I did see the Class P reference which I assume was dropped in favour of the KR392 xvi discharge.

Not sure if that means he improved or relapsed but his June discharge under 392/xvi means he can't stay in reserve surely.

Hopefully someone else knows more.

You could sort the sheets into order and attach them. Just give credit to the source.

TEW

[hrglynn]

Thank you all for your help and resources!  I suspect that, short of combing through letters or diaries, I may not find an exact description of how these medical boards were held--and there seems to have been quite a bit of variation anyway.  Even so, your suggestions have been very helpful for putting together a rough picture.

[TEW]

I found the Gilbert example from one of the lists in another topic:

I didn't keep track of which list from which page! I stuck with late 1917 lists which included GSW chest and checked for a pension file (WO364). Gilbert was the first out of about six I searched for before hitting on his file.

Whole process was only 15-20 minutes.

You don't really need to stick to GSW chest injuries from the lists as the process will be the same. Any differences in the process will be based on date (I think!).

Of course you may hit on a file where the man recovered enough for more service or otherwise not follow what you're after.

I'm not sure the pension files will explain the process but they should demonstrate it.

TEW

 

[ss002d6252]

On 02/02/2022 at 16:28, hrglynn said:

I also see that between his reclassification on 18 April and the Ministry of Pensions decision on 22 May, he was on furlough (26/4/18-6/5/18), so I'm curious what might have happened in the interim that would warrant a full discharge.  Obviously he had been severely wounded, but it seems that the May medical board must have decided he was in worse condition than in April.  

A man would be given 28 days leave pending his official discharge on demobilisation. If he was medically unfit, and would be entitled to a pension, then his details were passed across and he was given the discharge and a temporary pension (initially) for 4 weeks at the 100% rate, until the actual pension can be sorted.

Craig

[A Lancashire Fusilier by Proxy]

Apologies if this is too late to be of any interest, or may not be helpful as it relates to an officer, and moreover one in the New Zealand Expeditionary Force, but on this other thread https://www.greatwarforum.org/topic/293484-tifevisit-ideiesmo-ideepaw-ideisabate-ideentrans-ideenland-ideljack-idiercat-ideenreng-codes-in-2brc-wd/#comment-3053878 I posted on 7 December 2021 about (amongst others) a Captain Charles Dickson Harkness, whose sevice record (available online in the New Zealand Archives)  lost a leg as a result of being wounded in October 1917, and, having received notice that he was to be discharged from the army in May 1920 upon the New Zealand Force being disbanded, made an impassioned plea to be allowed to remain in the army until he had been fitted with a prosthetic limb presumably because that would be financially beneficial for him. His wish could not be granted owing to the fact that the entire force was being disbanded, but the implication is that, but for that, it could have been, thus indicating (I think) that there was considerable flexibility about the discharge process depending upon individual circumstances. if I am right about this, you have probably found that in any event if you have read a large number of files relating to men who were eventually discharged owing to medical conditions.

 

 

 

Edited 11 June , 2022 by A Lancashire Fusilier by Proxy