Separation Physical Prep Guide: What to Do Before Your Final Medical Exam

Your separation physical is one of the most underrated appointments in the entire transition process. Not because it is glamorous… but because it is often the last time you have a clean opportunity to make sure your medical record matches reality while you are still in.

This guide is about preparation and documentation, not medical advice. Always follow your branch guidance and talk to your clinic if you are unsure what applies to you.

If you want the big picture timeline first, start with the transition timeline and the complete separation checklist. If you are thinking about VA disability, the VA Disability Preparation Checklist is a good companion to this post.

What the Separation Physical Actually Is

Many service members hear “separation physical” and assume it is a quick “yep, you still have bones” visit.

In reality, the Department of Defense uses a standardized separation process often referred to as the Separation History and Physical Examination (SHPE) or Separation Health Assessment (SHA). The terms and workflow can vary by branch and clinic, but the concept is consistent: document your complete medical history and current concerns before you leave active duty.

If you want official references and service member resources, these pages are useful starting points:

• health.mil: Separation Health Assessment
• TRICARE: Separating from Active Duty
• VA: Separation Health Assessment

Why This Appointment Matters for VA Claims

If you plan to file a VA disability claim, you will repeatedly hear some variation of: “If it is not documented, it is harder.”

To be clear, this does not mean you should exaggerate, invent symptoms, or turn into a medical conspiracy theorist. It means your records should be accurate and complete. The VA generally needs evidence of a current condition, an in-service event or illness, and a link between them. Medical records and other evidence are part of that picture.

If you want to see how the VA describes evidence needed for disability claims, this is the official page:

• VA: Evidence needed for your disability claim

Real Example: What Good Documentation Looks Like

An E-5 with chronic lower back pain from a deployment documented it properly over 18 months:

• Initial visit: "Lower back pain after carrying heavy gear during rotation, radiating to left leg"
• Follow-up visits: PT notes, pain management referral, imaging ordered
• Separation physical: Provider summarized history, current symptoms, and treatment attempts

Result: VA claim approved within 3 months because service connection was clear.

Counter-Example: What Happens Without Documentation

An O-3 had shoulder pain for 2 years, never went to medical because "too busy" and "did not want it in my record."

• Separation physical: Mentioned shoulder pain for the first time
• Provider documented it as "reported shoulder discomfort, no prior treatment history"
• VA claim: Initially denied due to insufficient evidence of in-service occurrence

Result: Had to appeal with buddy statements and a nexus letter from a private doctor. Process took 14 months.

The difference? Documentation over time, not just a mention at the end.

When to Schedule It

The timing varies, but a common planning window is to schedule your SHPE before you separate and before terminal leave begins. Many clinics recommend scheduling within a set window prior to separation, and some installations get booked fast.

Practical advice that almost always holds true… do not wait until the last minute. If your clinic is backed up, “I tried” does not magically create appointment slots.

What to Do 2 to 4 Weeks Before Your Separation Physical

This is where most people can make the biggest improvement with the least effort.

1) Review your medical record for gaps

• Are there injuries or issues you discussed that never got documented?
• Are there long-running problems with no clear note trail?
• Are there missing outside records (urgent care, ER visits, off-base specialists)?

2) Write a one-page “issues list”

This is not a dramatic novel. It is a simple list you can hand to the provider or use to stay organized during the appointment.

3) Schedule follow-up visits for anything unresolved

If you have an ongoing issue that has never been properly evaluated, your separation physical is not the best place to start a multi-step workup. If you have time, schedule the appropriate visits now so the separation physical is a summary, not the first mention.

4) Do not assume “they already know”

Military medicine is full of different clinics, systems, and providers. If something matters, make sure it is explicitly discussed and documented.

What to Bring to the Appointment

• Your one-page issues list
• A short list of medications and supplements (even if it is “none”)
• Relevant documentation for off-base care (if applicable)
• Any specific questions you want answered

Common Mistakes That Cause Problems Later

• Minimizing everything: “I’m fine” is not a personality trait. If something is real, say it clearly.
• Assuming it is in the record: verify. Do not guess.
• Waiting too late: late scheduling creates rushed outcomes.
• Treating the separation physical as the first visit: complex issues often need follow-ups, referrals, imaging, or documentation over time.
• Not getting copies of records: you want your own copy for your life, not because you distrust the system, but because systems are systems.

Specific Issues That Get Missed Frequently

Based on what actually causes problems later, these are the conditions people regret not documenting properly:

1. Hearing Loss and Tinnitus

If you worked around aircraft, heavy equipment, guns, or any loud environment and now have ringing in your ears or hearing issues, get it documented. Tinnitus is one of the most common VA claims, and it is much easier to connect if there is a documented baseline before separation.

2. Joint and Back Pain

Knees, ankles, shoulders, lower back. If you have been "toughing it out" for years, your separation physical is not the time to suddenly discover stoicism. Document the pain, what causes it, how it limits you.

3. Mental Health (Including Sleep Issues)

Anxiety, depression, PTSD, insomnia. If you have been dealing with it quietly or self-medicating with energy drinks and gym time, at least get it in the record. You do not need to commit to long-term treatment right now, but acknowledging it creates a paper trail.

4. Migraines and Headaches

Frequent headaches that interfere with work or life. If you have been popping ibuprofen regularly, that is worth mentioning.

5. Skin Conditions

Eczema, psoriasis, chronic rashes, scars from service-related injuries. These are easy to overlook but worth documenting.

6. Gastrointestinal Issues

IBS, chronic stomach problems, food intolerances that developed during service. These get dismissed as "stress" but can qualify for VA compensation if service-connected.

What to Do If Your Records Are Incomplete

Sometimes you review your records and realize half your medical history is missing. Maybe you got treated at a different base. Maybe you went to urgent care off-base. Maybe visits just never got entered properly.

Here is what you can do:

Option 1: Request Missing Records Before Your Separation Physical

If you have documentation from other military treatment facilities, civilian providers, or emergency rooms, request those records now and bring copies to your separation physical. The provider can reference them and ensure key information gets summarized in your final documentation.

Option 2: Use Your Separation Physical to Fill Gaps

If something legitimately happened but was never documented, tell the provider during your separation physical. They cannot retroactively create records from 3 years ago, but they can document "patient reports history of X injury during Y timeframe, no prior documentation available."

This is not as strong as contemporaneous documentation, but it is better than nothing.

Option 3: Gather Buddy Statements and Personal Evidence

If you have service-connected issues with no medical records, you can still file VA claims later using buddy statements (written statements from people who witnessed your injury or condition), personal statements, and nexus letters from private doctors. It is harder, but not impossible.

What Happens After the Separation Physical

After the appointment, the best next steps are usually boring and useful:

1. Confirm any follow-up appointments that were recommended.
2. Request copies of key records and ensure you have access after separation.
3. If filing VA claims, keep your documentation organized so you are not hunting for paperwork under stress later.

Frequently Asked Questions

When should I schedule my separation physical?

Schedule 90-120 days before your separation date, before terminal leave begins. Some installations allow scheduling up to 180 days out. Check with your military treatment facility for specific timelines. Do not wait until the last 60 days because popular months fill up fast.

What is the difference between SHPE and SHA?

SHPE (Separation History and Physical Examination) and SHA (Separation Health Assessment) are different names for the same process. The Air Force typically uses SHPE. Other branches use SHA or similar terms. Both refer to your final medical evaluation documenting your health status before separation.

How long does a separation physical take?

The appointment itself usually takes 30-60 minutes. Plan for 1-2 hours total including wait time, paperwork, and any additional coordination. If you have multiple complex issues to discuss, it might take longer. Bring your written issues list to keep things organized and efficient.

What happens if I forget to mention something at my separation physical?

You can still file VA claims later even if something was not documented at your separation physical. However, you will need to establish service connection through other evidence like treatment records from after service, buddy statements, or nexus letters from doctors. It is harder but not impossible.

Can I request a copy of my separation physical documentation?

Yes. You should request copies of all separation-related medical documentation for your personal records. You can access your military medical records through the TRICARE Online Patient Portal, or request copies from your military treatment facility's records office. Having your own copies prevents future headaches if records get lost or delayed.

Do I need to exaggerate symptoms to get them documented properly?

No. Be honest and specific about your symptoms. Exaggeration can backfire if your records do not match reality during VA exams later. Instead, focus on accuracy: when symptoms started, what makes them better or worse, how they impact your daily life and work. Specific, truthful descriptions are more useful than dramatic ones.

What if my provider dismisses my concerns during the separation physical?

If you feel your concerns were not adequately addressed, you have options: (1) Request a follow-up appointment to document specific issues in more detail, (2) Ask to speak with patient advocacy at your military treatment facility, (3) Seek a second opinion from another provider, (4) Document your concerns in writing and submit through your chain of command if necessary. Do not let valid issues go undocumented just because one appointment did not go well.

Should I bring my spouse or a friend to the appointment?

If you are dealing with cognitive issues, anxiety, or tend to forget things under stress, having someone with you can help. They can take notes, remind you of things you wanted to mention, and provide a second set of ears. Most clinics allow this, but confirm ahead of time. For straightforward appointments, it is not necessary.

What if I am already on terminal leave and realize I forgot something?

You can still file VA claims after separation even if documentation is incomplete. Focus on getting any available civilian medical records, buddy statements from people who witnessed your condition, and statements from family. For future claims, consider working with a Veterans Service Organization (VSO) who can help navigate cases with limited documentation.

Final Thoughts

The separation physical is not about gaming the system. It is about accuracy. If your record reflects reality, you have more options and fewer regrets later.

If you are early enough in your timeline, use that advantage. If you are late, do what you can now and get organized fast… because the calendar is undefeated.

About the author: Bruce Goren is an Air Force member retiring in February 2026. As part of his transition, he participated in the SkillBridge program through AllegiantVets and later completed on-the-job training through Service2Software.