Steps to help complete physical limitation form

Published July 11, 2012
By Master Sgt. Erica Shepherd
Health Promotion Flight NCOIC

KEESLER AIR FORCE BASE, Miss. -- The purpose of Air Force Form 469 duty limiting condition report is to convey physical limitations to the commander when a member's health, safety and well-being, mission safety or abilities to effectively accomplish the mission are at risk (Air Force Instruction 10-203 paragragh 1.1). Form 469 functional limitations that impact unit fitness will be processed in accordance with AFI 10-248, Fitness Program.

The exercise physiologist will use Air Force Form 422. Physical Profile Serial Report, to document exercise program evaluations, fitness prescription instructions, fitness testing exemption recommendations, and clearance for unrestricted fitness participation or fitness testing (AFI 10-203 paragraph 2.9).

Although the Form 469 and Form 422 processes are useful tools, they can be frustrating and confusing because there are many different people involved. To help clarify the process, follow these steps:

1. The member makes an appointment with their provider and the provider initiates the member's electronic 469 via the Aeromedical Services Information Management System website.

2. Within the 81st Medical Group, the 469 will be electronically signed off by a provider, force health manager and profile officer (2-3 day time frame).

3. After all e-signatures are complete, the 469 is then emailed to the duty limiting condition inbox corresponding with the member's squadron. At this point, if there is a problem with the 469 or the member's commander has not seen it, the member needs to contact their provider.

4. The member receives official 469 from DLC inbox recipients (commander, first sergeant,unit health manager or unit deployment manager ) in accordance with AFI 10-203 paragraph 2.14. At this point, if the member has not received the 469, the member needs to contact his/her commander.

5. The member takes a hard copy of their 469 to their unit fitness program manager.

6. The UFPM determines if the member needs a 422 generated (physical training test soon or 469 greater than 30 days) in accordance with AFI 10-203 paragraph 2.9.5.4.

7. If a 422 is needed, the UFPM places the member on duty limiting condition roster via the health and wellness center calendar.

8. The health and wellness center's exercise physiologist reviews the member's medical condition and generates a 422 accordingly.

9. A 422 needs to be automatically e-signed by the exercise physiologist, force health manager, and profile officer (2-3 day time frame). At this point if there is a problem with the 422, the member needs to contact the HAWC.

10. After all e-signatures are complete, the 422 is emailed to the DLC inbox corresponding with the member's squadron.

11. The member receives the official 422 from DLC inbox recipients in accordance with AFI 10-203 paragraph 2.14.

12. Member takes hard copy of 422 to the fitness assessment cell when reporting for their physical training test.

The entire 469/422 process can take seven to 10 days. There are a lot of people involved in this process. Most of it happens electronically. However, members should be sure to stay on top of the process. For more information call 228-376-3170.