Promotion Board Recommendations  Besides providing a numerical score for each officer, the promotion board will make a promotion recommendation. The majority recommendation (at least 3 of 5 board members) becomes the overall board recommendation. For the Permanent Grade there are two options:            Recommend - This means that if the success rate is 100 percent, the board feels this            officer should be promoted. Just because a board recommends an officer doesn’t             necessarily mean the officer will be promoted. Their score must also rank the officer            high enough based on the success rates to be above the success line (See Promotion            Process in the Table of Contents).            Not Recommend - This means that regardless of the score or success rate, the             board does not feel this officer should be promoted.        If an officer gets an overall board recommendation of “Not Recommend” two consecutive years in a row in the permanent grade, he/she will be referred to an involuntary retirement/separation board. The promotion board members are instructed of the consequences of a “Not Recommend” and do not make this decision lightly. For the Temporary Grade there are three options:            Recommend - This means that if the success rate is 100 percent, the board feels this            officer should be promoted. Just because a board recommends an officer doesn’t            necessarily mean the officer will be promoted; their score must also rank the officer             high enough based on the success rates to be above the success line (See Promotion            Process in the Table of Contents).            Defer - This means that the board feels this officer is not quite ready to serve in the            next higher grade but is an otherwise good officer that should be retained in the            Corps. An officer receiving a “Defer” from the promotion board will be eligible for            promotion review the following promotion year.             Not Recommend - This means that regardless of the score or success rate, the board            does not feel this officer should be promoted. Officers will also receive an automatic            “not recommend” at the end of the board review if they were reported by OFRD as            not meeting readiness standards at the time of the December quarterly check. If an officer gets an overall board recommendation “Not Recommend” in the temporary grade, he/she will be referred to an involuntary retirement/separation board. The promotion board members are instructed of the consequences of a “Not Recommend” and do not make this decision lightly. If Promotion Boards recommend that an officer be promoted and there is an absence of any adverse actions, an officer may be considered for promotion until successful unless the officer scores/ranks in the bottom decile (10 percent) for their category and grade three consecutive years.  Officers who score/rank in the bottom decile (10 percent) three consecutive years are removed from Temporary Grade promotion eligibility and will be referred to a Retention Board.  The Retention Board may reinstate the officer’s Temporary Grade eligibility or recommend the involuntary separation of the officer and/or make other recommendations for final decision made by the Assistant Secretary for Health.