Never got downgraded ~lol~ I did try for it during reservist
(hypertension), but such cases seldom reach beyond the unit MO
level. Everyone knew the main purpose is to siam IPPTs so, as long
as it's credible on paper, you'll be excused accordingly. Near the
end of my cycle, about a third of my unit personnel used to sit on
the stadium benches "cheering on" during the fitness testings.
Quite farcical, even though we're one of the top outfits in FATEP
(field-exercise) scoring.
I don't think I was even sick, but just happened to be
hyperstressed from work that day. Just manipulated the system, lah.
Asked for medical board, was told to get treated outside &
submit the reports, then acted blur -- "what report?" -- when
called back for medical review. Each time, it'd be a new (&
usually friendly) MO who only has the notes inside my docket for
appraisal. Attend B/excuse IPPT-type chit issued, with verbal
instructions on what to bring back for the next FFI. Repeat ad
nauseum. Sometimes my unit didn't get the docket back for an ICT,
so my regular MO would pass the buck again. Lo & behold,
there'd be a surge of such "hardship" cases in time as my unit
itself got older (& the training schedule got tighter &
tighter, so much so the MO has to finish dealing with the reporting
sick out in the field).
Dunno about active time, which was also quite a long time back in
my case. Each unit, or rather medical center, has its own
institutional culture. My own understanding is that, as much as
possible, that command level is "encouraged" to solve its own
"problems", before involving the higher-ups or elsewhere. Medical
Boarding seeks a permanent PES downgrading, which usually entails
re-vocationing & re-coursing. There were some serious injury
cases in my time, one famous one involving a M113 explosion that
left almost a full detachment of mortarmen incapacitated. But, as
far as I knew, only one of the casualties was Boarded. Another
became a mess boy, the other two Hokien peng followed the rations
truck, while the two NCOs kept their combat status. In those days,
formal downgrading would also involve an unwelcome cut in service
pay (different vocations were paid differently then), which might
have also contributed to my unit preferring to solve matters
internally.