Parents with medical backgrounds and DoDMERB

AeroMed1

Parent of USNA candidate
5-Year Member
Joined
Dec 28, 2010
Messages
22
After reading some of the DoDMERB threads and due to what we are dealing with as parents, I want to share a few thoughts with those of you with medical backgrounds, when filling out your candidates's medical information forms. This may apply to those of you who are nurses, doctors, PA's or NP's and similar.

First always be 100% honest. Always.
Use layman's terms and not the medical terms that you know. It appears (in our opinion) that in some cases DoDMERB is flying through the records, and if they see certain words ....ZAP......the record is tossed into the remedial or DQ basket.

Our candidate is dealing with a remedial due to the parents description of an emergency room visit as an INFANT. We used a big word as to what they thought might be the problem or diagnosis. And in reality, that diagnosis can only be given after surgery. Our candidate never had that diagnosis, never had surgery, was never hospitalized, etc. and actually HAS NO diagnosis other than normal kid. No meds, no nothing. Was seen in the ER and sent home. But candidate is now going the remedial route, digging up records and more. Yes, and is working with Mullen.

And once the remedial process starts it goes on and on and on and on....

As parents we feel awful. :frown: In trying to be complete we have been bitten in the bum. We wrote down what we were told might be the problem, and that "might be this" is not mentioned in the actual chart! GO FIGURE!

So don't throw out those big words. It is simply amazing that one word given in a history could cause so much frustration.

And if you get through to DoDMERB, and they tell you IF YOU WILL FAX the information TODAY, they might have an answer TODAY, don't believe it. :thumbdown: We drove 2 hours each way, to get the chart, and we sent it, and we still don't have an answer. It was not worth the drive, etc. This could have been done via snail mail with the same results.

Again candidate is dealing with it, but the wheels are spinning in the mud. Sooooo frustrating. Candidate will start again after the holidays.

Again, just thoughts. Good luck!
 
It appears (in our opinion) that in some cases DoDMERB is flying through the records, and if they see certain words ....ZAP......the record is tossed into the remedial or DQ basket.

As they should be.

The Medical Reviewer who is first looking at the file is going by a DOD standard (6130.03) that has over 400 different conditions that can result in a DQ or a remedial.

If an applicant has a medical condition that may not meet the standards, it is then sent to DODMERB physician for their review.

The DODMERB doctors are the only authority to determine that an applicant does not meet the medical standards - not the initial reviewer.

To categorize the efforts of the dedicated personnel at DODMERB as "flying through the records" does them a great disservice.

(Yes, even injuries or other medical conditions diagnosed and/or treated as INFANTS can be disqualifying, and yes, they should be disclosed. And yes, your advice concerning honesty is 100% correct, as "failure to disclose information" is a DQ in and of itself.)
 
Ouch. ( insert smiley head banging the wall here). I can understand your frustration! We did get a remedial and it was turned around in hours but that was in september or the very beginning of October. I think the rush hadn't hit yet. But I also knew in advance that there "could" be two possibilities for a snag in ds's medical history and I chased down those records or what i could find even before the original examination in August. I had a full out search for records going and tracing medical practices no longer in business, etc, etc. I thought i was going to have to get to a place called IronMountain! Omg, what a hassle! But I knew it was coming because all I had read on these threads months in advance. ( lots of time on my hands) And it worked out,
Sounds like yours came out of left field and that must have been a kick in the gut! From what you have explained it sounds like something that will be turned around, I sure hope so because I do know the amount of work your candidate has put in up to this point! Please let us know how this works out and any tips you find for negotiating this process for others to learn from. It sure helps me.
 
I'm sorry your misinformation and your attitude are clouding your issues. I'm more concerned that you are listed as a parent and you are trying to incite those who may not have begun the process yet. But, if someone is working directly with me, they know exactly where they stand...not in the ball park...exactly. I am one of the most responsive civil servants in the Federal Government...bar none!

Sometimes folks don't like the answers, but at least they get the answers without pomp and circumstance. So, if you are having a bad experience or think you are, send me an email. If you already have, don't think I equate AeroMed1 to a real name. Cut and paste your posting below, provide the applicant's complete name and last 4 SSN, tell me you are AeroMed1 and send me the email. The last 2 weeks I've been on use or lose leave and have been working at least 6 hours per day helping folks. I will be going to bed early tonight and plan to have fun tomorrow, but send me your email and I can enlighten you:thumb:
 
I just did a sort of my email messages. Becasue of the high volume I receive, I sort by calendar quarters. Of the 10,981 email messages I've received since 1 Oct 2010, there are Zero that have AeroMed1 in the address, subject, or text of the message. So, unless I receive a message where I can work to resolve whatever problem exists or can correct any misperception that one might have, I'll just presume some folks just like to sully the water.:confused:
 
Ok then, I will quietly park my Unicorn over here out of (line of fire) way.:zip:
 
Not trying to put Mullen and DoDMERB on defense

Mullen thank you for your response, but you will not find an email from the parents (AeroMed1). We are letting our candidate handle the parent's bad choice of a single word.

Not trying to put you or anyone on the defensive but the view expressed is sincere and the ?next poster Luigi verifies exactly what was expressed. If there is a single word expressed in a medical history that falls into the list of "throw-out" words, that is exactly what happens. And you prove also the rapid reading expressed in OP. It was stated clearly that the word that caused the remedial was written by we parents. It was never a diagnosis and after getting the record it is not even in the medical record. It was what we remember being told that would might be ruled out.

You are also missing how horrible we feel. This is our fault. If we had used layman's terms, there would not be a remedial.

We stand behind our opinions. Do not use medical terms unless there is an actual diagnosis. Do not put "Seen in emergency room at age 3 months for possible bla bla bla (medical term)." Instead write "seen in ER for (and just put in symptoms in laymen's terms)."

Glad that we all agree on 100% honesty but it seems that you do not want to hear it.

It seems like we read that you want to know what you can do to make things better here. By attacking us you will most likely make others afraid to post their concerns. That is great for you, so that you won't have to deal with it. There are other forums where the same problems and frustrations are reported. We wish we had read this forum before EVER filling out our candidates medical history.

Yes Mullen you responded to one email, but nothing further with our candidate regarding other emails that have been sent to you, in the manner that you requested. It has been about 4 weeks.

Lynpar, we might update if we can find an armored vehicle to report from, first.:cool: We will try to do this. This is frustrating but we will deal with it. We would just like to prevent others from making the same mistake. We stand firm behind our concerns.
 
How do you know a remedial would not have been requested if you hadn't listed it the way you did?

I do anywhere between 10-20 of these types of physicals a week and if I see ER visit listed on a candidate physical (even if it's as an infant) I'm going to ask questions.

I agree that one should not speculate on the forms; however, if you know the name of the diagnosis then write it. Writing "Possible bowel obstruction" on the form isn't going to generate less work than writing "Ileus" as an example.

I understand your frustrations, I went through it twice...once as a SA candidate almost 15yrs ago (prior to this immediate feedback email stuff) and once as a medical school candidate and both times with remedials. It's a pain, but the process works in the end. Working at DoDMERB is a pretty thankless job as they are the ones who get the "pleasure" of disqualifying people from their "dream". I promise you, a year from now, you will look back on it as a minor speed bump and nothing to get too upset about. (Assuming the issue is as non-significant as mentioned).
 
"Yes Mullen you responded to one email, but nothing further with our candidate regarding other emails that have been sent to you, in the manner that you requested. It has been about 4 weeks."

Very doubtful, but pls have your candidate email within the next 24 hours. I will be going to a movie, shoveling snow, having dinner, and playing Racquetball during that time. But if the candidate emails me within the next 24 hours, I will respond promptly. My email address is Larry.Mullen@dodmerb.tma.osd.mil:thumb:
 
Further response

Thanks kp2001 for your thoughts. This is just a bump in the path and we are staying with friends who are going through a similar situation with their candidate. They are best friends (as we are) making a choice together years ago to go the military route and they are helping each other cope just as we parents cope.

Again just a bump in the road that should have never happened.

If every record is scrutinized over an infant's visit to an ER, you will be very busy in the years ahead. Due to lack of health insurance, that is where many receive basic care. As you know, when a physician lays out the plan you are given worst case scenarios, and that is probably what was said to us, and that was a word we remembered being used 16+ years ago. It was never stated in the record, it was not a diagnosis and we are responsible for our candidate being left with that word. As stated before, our candidate has no health problems, no diagnosis of any kind other than normal kid, normal growth, no meds, etc.

We stand by what we believe. It is best just to write down symptoms and not use ANY medical terms unless they are an actual diagnosis or written in the record. If you put them out there, they will be used against your candidate. Even though tests were normal and provided, they will be used against you.

You gave an example and now we will. I think I saw this one on another forum. Let's say your child has the flu, type A x 2. Child has lingering headaches for 2 weeks post flu. You see an aggressive physician or perhaps as a parent you are just worried. You know they are due to the flu, but just to be safe a brain scan is ordered and as a physician, you must put down a reason for the brain scan. As a parent, someone might say to you "Oh, lets just make sure there is no brain tumor or something else going on here." So you might write down or physician might write down "Brain Scan due to headaches to rule out brain tumor" just to be sure health insurance pays for the scan. The scan comes back normal, the headaches go away and were felt to be status post flu. Ten years go by and kid applies to a military academy. There have been no further headaches, etc. Normal kid, athlete, busy. Parents write on history...headaches at age 6 after the flu. A brain scan was done to be sure there was no brain tumor. Kid either gets a remedial or DQ. Somehow 10 years later a single, normal brain scan can DQ a candidate.

This example is a bit far fetched, but I read about a similar situation on another forum, and the kid was a DQ.

The decisions you make may not end a dream. There are parents who will fight for their child and the candidates will fight for what is right and just. There might not be a correction in time to keep military academy desires active (that plan might be gone), but perhaps the ability to join after college, or to join an ROTC unit while in college is saved.

Again, thanks for your thoughts and thanks for continuing to prove what I said originally to be true. I am shocked that an infant's visit to an ER is a red flag. That is where most parents end up after hours, also, as most pediatricians stay home and send kids there to be safe. "Just to be safe why don't you take your baby by the ER and let them check a urine sample." In an age of malpractice, physicians must also cover their bums.

I will be amazed if anyone makes it through without a remedial.
 
Response to Mullen

No, no further emails until next week for our candidate. Enjoy your break and enjoy bringing in the new year. Perhaps you can respond to the ones you missed next week.
 
I don't take breaks. Just little interludes. But, your choice:thumb:
 
You gave an example and now we will. I think I saw this one on another forum. Let's say your child has the flu, type A x 2. Child has lingering headaches for 2 weeks post flu. You see an aggressive physician or perhaps as a parent you are just worried. You know they are due to the flu, but just to be safe a brain scan is ordered and as a physician, you must put down a reason for the brain scan. As a parent, someone might say to you "Oh, lets just make sure there is no brain tumor or something else going on here." So you might write down or physician might write down "Brain Scan due to headaches to rule out brain tumor" just to be sure health insurance pays for the scan. The scan comes back normal, the headaches go away and were felt to be status post flu. Ten years go by and kid applies to a military academy. There have been no further headaches, etc. Normal kid, athlete, busy. Parents write on history...headaches at age 6 after the flu. A brain scan was done to be sure there was no brain tumor. Kid either gets a remedial or DQ. Somehow 10 years later a single, normal brain scan can DQ a candidate.

And this absolutely should be a DQ with a likely waiver. The "norm" for flu or any other illness does not include 2 weeks of new onset headaches. Someone who presents like that very likely may get imaging and all it would then take is a quick review of the FULL medical record to see that everything was "normal". Remember, the reviewers do not have access to an entire medical record, they only see what is sent in. If something is "different" then they request further information to be able to make an informed decision.

I don't think people should look at a medical DQ as a problem at all until the waiver has been denied.

The decisions you make may not end a dream. There are parents who will fight for their child and the candidates will fight for what is right and just. There might not be a correction in time to keep military academy desires active (that plan might be gone), but perhaps the ability to join after college, or to join an ROTC unit while in college is saved.

Medical accession standards are pretty much the same for any route taken. If it's a DQ for a service academy 99.999% of the time it is a DQ for any officer accession. (I can think of one example that wouldn't be and that would be color blindness for someone who is going into certain fields in the Navy, eg Medical.......actually still a DQ, but gets waived usually)

I am shocked that an infant's visit to an ER is a red flag

It's not the visit, it's the reason for the visit or the outcome of the visit. Most people will just write "ER age XXX" some will write more which makes it easier, others will write less. That's why you see DQ's for it, because they simply need more information. The listing of the visit simply means for me that I need to ask an additional question or two.
 
Forgot to add:

I also want to remind people that once someone is in the military, the military (i.e. the taxpayers) have bought on paying for that persons health care. If someone comes in with a pre-existing condition that isn't noted prior to entering and then "flares" or simply recurs guess what, it's now almost 100% of the time "service-connected" and now the taxpayer gets to pay for that care for the rest of that person's life. Or say they don't have a condition, but are more prone to it due to other things they have (say >8 diopters on their eyeglass prescription), and then they develop that condition....

This isn't the primary reason for all the DQ'ing conditions (that is due to deployment/job limitations), but is a secondary factor that policy makers likely take into consideration.
 
DodMERB Decisions

So if I am reading this correctly, and another thread correctly, a decision for a remedial or DQ could be decided on what is a "possible" diagnosis, not the end result or actual diagnosis? Many medical problems mentioned here may never present again, and if it has been ruled out, I do not understand why the DQ?
kp2001 You must have missed the swine flu (A) last year. I had plenty of patients with headaches. Some were untreated sinus infections, but most were just what I saw with that specific flu.
It would seem decisions would be based on test outcome or final impression/conclusion, not the pre diagnosis. That is like going to the hospital for a possible heart attack and finding out that it was the tacos you ate at lunch. There is no comparison.
I am learning and a bit surprised.
 
re: forgot to add

I understand the taxpayer. But I would bet that a 100% normal record would fall to those who did not have much healthcare or perhaps did not have medical insurance growing up. The students with good healthcare that is well documented, will run into problems. That is backwards.
 
Forgot to add myself

And we should pay for their healthcare. We do not do enough.
 
So if I am reading this correctly, and another thread correctly, a decision for a remedial or DQ could be decided on what is a "possible" diagnosis, not the end result or actual diagnosis? Many medical problems mentioned here may never present again, and if it has been ruled out, I do not understand why the DQ?
kp2001 You must have missed the swine flu (A) last year. I had plenty of patients with headaches. Some were untreated sinus infections, but most were just what I saw with that specific flu.
It would seem decisions would be based on test outcome or final impression/conclusion, not the pre diagnosis. That is like going to the hospital for a possible heart attack and finding out that it was the tacos you ate at lunch. There is no comparison.
I am learning and a bit surprised.

Probably wasn't particularly clear. The decision is made based on the diagnosis. If it said sinusitis then it would be clear to everyone that it wasn't some mass causing the headaches, not migraines, etc etc.

Basically the review is of the information written on the forms. They don't have access to the full records. So if someone writes on a form "ER Visit, MRI to r/o mass" and not much more then they are going to want more information.

I think people use the word DQ as a "four letter word". In most instances it's not, it's simply a request for more information so they can determine that yes, the person simply had "sinusitis" or "viral headache" etc etc.

I definitely hit the swine flu, had fun vaccinated 300+ people just prior to deployment and then got to the desert where we were quarantining pretty much anyone with a fever in tents. I personally didn't have anyone or hear of anyone presenting with two weeks of headaches in association with it(headache for a day or two, not two weeks though). Might have had slightly different presentations than the community given our otherwise "healthy" population though.
 
Confused post

kp2001 I was not clear in my post, so sorry about that. It is my understanding of the ROTC process that if a waiver is needed they will let the student start college and then complete the waiver during that first semester. That does not hold true with a military academy.

You state above that remedial or DQ is based on diagnosis. That did not happen to our candidate. It was done based on what we wrote. There was no diagnosis given. So could your statement be wrong? Our candidate has no working diagnosis, other than normal healthy kid.
 
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No, no further emails until next week for our candidate. Enjoy your break and enjoy bringing in the new year.
you can respond to the ones you missed next week.

I do not understand why you are attacking a resource who has offered to help you out. Believe me, if you are having trouble handling this, it is nothing compared to what you are going to go through as this process continues and if your child receives an appointment to the academy. There is lots more red tape, sleepless nights, hoops to jump through, and rollercoaster rides ahead. Larry Mullen is one of the best resources you have. I urge you to take him up on his offer and email him. You will be one day closer to your child's dream.
 
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